Date of Submission


Document Type


Degree Name

Doctor of Health Science


Health Sciences

First Advisor

Karl E. Minges, PhD, MPH

Second Advisor

Jenna Cooke, DNP, APRN, FNP-C, CGRA

Third Advisor

Brian McCambley, DHSc, PA-C


Genetic Predisposition to Disease, Neoplastic Syndromes, Hereditary, Public Health, Genetic Counseling, Telemedicine


Genetic disorders, Health risk assessment, Cancer--Risk factors, Health--Social aspects, Genetic counseling, Medical telematics


There is mounting evidence that genetic testing can help inform individuals about their breast, ovarian, pancreatic, colorectal, and prostate cancer risk. With this information, a mutation carrier can determine the right procedural path to reduce their cancer or recurrence risk. Further guidance with the decision comes from national evidence-based guidelines and discussions with genetic counselors or trained healthcare providers. This study aimed to identify the factors associated with whether a patient at high risk of cancer undergoes a referral to genetic testing and the factors that influence that decision. A secondary analysis was conducted of local source data from a proprietary clinical database that included 870 individual, discrete patients from July 1st, 2023, to November 30th, 2023. The eligibility criteria included patients seeking and referred to preventative screening studies, such as mammography, MRI, or ultrasound. The dependent variable was whether the patient accepted or rejected the genetic testing recommendation, and the independent variables were barriers, sociodemographic factors, genetic history of cancer, and comparative medical history. The analysis yielded information about the factors that contribute to a decision to be or not be tested for a genetic predisposition to cancer. Results from the research can be the basis for strategies to improve the number of patients who accept a recommendation to seek genetic testing. The outcomes also highlighted significant gaps for specific groups of patients.

Available for download on Monday, November 17, 2025