Ancestry-Specific Hypothetical Genetic Feedback About Lung Cancer Risk in African American Individuals Who Smoke: Cognitive, Emotional, and Motivational Effects on Cessation

Genetic factors play an important role in the risk of developing lung cancer, a disease that disproportionately affects African American (AA) individuals who smoke. Accumulating evidence suggests that specific ancestry-informative genetic markers are predictive of lung cancer risk in AA individuals...

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Main Authors: Joel Erblich, Khin Htet, Camille Ragin, Elizabeth Blackman, Isaac Lipkus, Cherie Erkmen, Dina Bitterman
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Behavioral Sciences
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Online Access:https://www.mdpi.com/2076-328X/15/7/980
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author Joel Erblich
Khin Htet
Camille Ragin
Elizabeth Blackman
Isaac Lipkus
Cherie Erkmen
Dina Bitterman
author_facet Joel Erblich
Khin Htet
Camille Ragin
Elizabeth Blackman
Isaac Lipkus
Cherie Erkmen
Dina Bitterman
author_sort Joel Erblich
collection DOAJ
description Genetic factors play an important role in the risk of developing lung cancer, a disease that disproportionately affects African American (AA) individuals who smoke. Accumulating evidence suggests that specific ancestry-informative genetic markers are predictive of lung cancer risk in AA individuals who smoke. Although testing for, and communication of, genetic risk to patients should impact health and screening, results are mixed. The goal of this study was to evaluate the effects of genetic risk communication that also included ancestry-specific risk information among African American individuals who smoke. Using an experimental design, African American individuals who smoke (n = 166) were assigned randomly to receive hypothetical genetic test results that indicated (1) low vs. high genetic risk for lung cancer (“Risk”) and (2) European vs. African Ancestry (“Ancestry”). We hypothesized that participants who had been told that they were both at high risk for lung cancer based on genetic markers prominent in African persons at risk of lung cancer, and that they have African ancestry, would exhibit increases in cognitive (perceived lung cancer risk), emotional (cancer worry and psychological distress), and motivational (motivation to quit smoking) factors shown to predict longer-term health behavior change. Results revealed significant and moderate-to-large effects of Risk for all outcomes. There was also a significant Ancestry effect on perceived lung cancer risk: increased risk perceptions among participants who learned that they have high African genetic heritage. Path analytic modeling revealed that cognitive and emotional factors mediated the effects of both Risk and Ancestry feedback on motivation to quit smoking. Findings further highlight the importance of incorporating ancestry-specific genetic risk information into genetic counseling sessions, especially in underserved populations, as doing so may impact key cognitive, emotional, and motivational factors critical to behavior change.
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spelling doaj-art-8b86732bc2b64d10bb9d943dfbc388f32025-08-20T03:58:26ZengMDPI AGBehavioral Sciences2076-328X2025-07-0115798010.3390/bs15070980Ancestry-Specific Hypothetical Genetic Feedback About Lung Cancer Risk in African American Individuals Who Smoke: Cognitive, Emotional, and Motivational Effects on CessationJoel Erblich0Khin Htet1Camille Ragin2Elizabeth Blackman3Isaac Lipkus4Cherie Erkmen5Dina Bitterman6Department of Psychology, Hunter College, City University of New York, New York, NY 10065, USADepartment of Psychology, Hunter College, City University of New York, New York, NY 10065, USACancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USACancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USADepartment of Psychiatry, Duke University, Durham, NC 27708, USADepartment of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19122, USADepartment of Psychology, Hunter College, City University of New York, New York, NY 10065, USAGenetic factors play an important role in the risk of developing lung cancer, a disease that disproportionately affects African American (AA) individuals who smoke. Accumulating evidence suggests that specific ancestry-informative genetic markers are predictive of lung cancer risk in AA individuals who smoke. Although testing for, and communication of, genetic risk to patients should impact health and screening, results are mixed. The goal of this study was to evaluate the effects of genetic risk communication that also included ancestry-specific risk information among African American individuals who smoke. Using an experimental design, African American individuals who smoke (n = 166) were assigned randomly to receive hypothetical genetic test results that indicated (1) low vs. high genetic risk for lung cancer (“Risk”) and (2) European vs. African Ancestry (“Ancestry”). We hypothesized that participants who had been told that they were both at high risk for lung cancer based on genetic markers prominent in African persons at risk of lung cancer, and that they have African ancestry, would exhibit increases in cognitive (perceived lung cancer risk), emotional (cancer worry and psychological distress), and motivational (motivation to quit smoking) factors shown to predict longer-term health behavior change. Results revealed significant and moderate-to-large effects of Risk for all outcomes. There was also a significant Ancestry effect on perceived lung cancer risk: increased risk perceptions among participants who learned that they have high African genetic heritage. Path analytic modeling revealed that cognitive and emotional factors mediated the effects of both Risk and Ancestry feedback on motivation to quit smoking. Findings further highlight the importance of incorporating ancestry-specific genetic risk information into genetic counseling sessions, especially in underserved populations, as doing so may impact key cognitive, emotional, and motivational factors critical to behavior change.https://www.mdpi.com/2076-328X/15/7/980genetic counselinglung cancerrisk perceptionshealth behaviorsmokingexperiment
spellingShingle Joel Erblich
Khin Htet
Camille Ragin
Elizabeth Blackman
Isaac Lipkus
Cherie Erkmen
Dina Bitterman
Ancestry-Specific Hypothetical Genetic Feedback About Lung Cancer Risk in African American Individuals Who Smoke: Cognitive, Emotional, and Motivational Effects on Cessation
Behavioral Sciences
genetic counseling
lung cancer
risk perceptions
health behavior
smoking
experiment
title Ancestry-Specific Hypothetical Genetic Feedback About Lung Cancer Risk in African American Individuals Who Smoke: Cognitive, Emotional, and Motivational Effects on Cessation
title_full Ancestry-Specific Hypothetical Genetic Feedback About Lung Cancer Risk in African American Individuals Who Smoke: Cognitive, Emotional, and Motivational Effects on Cessation
title_fullStr Ancestry-Specific Hypothetical Genetic Feedback About Lung Cancer Risk in African American Individuals Who Smoke: Cognitive, Emotional, and Motivational Effects on Cessation
title_full_unstemmed Ancestry-Specific Hypothetical Genetic Feedback About Lung Cancer Risk in African American Individuals Who Smoke: Cognitive, Emotional, and Motivational Effects on Cessation
title_short Ancestry-Specific Hypothetical Genetic Feedback About Lung Cancer Risk in African American Individuals Who Smoke: Cognitive, Emotional, and Motivational Effects on Cessation
title_sort ancestry specific hypothetical genetic feedback about lung cancer risk in african american individuals who smoke cognitive emotional and motivational effects on cessation
topic genetic counseling
lung cancer
risk perceptions
health behavior
smoking
experiment
url https://www.mdpi.com/2076-328X/15/7/980
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