Genetic testing decision-making for cancer predisposition is inherently complex. Understanding the mechanisms and influencing factors of the decision-making process is essential for genetic counselling and has not yet been investigated in Switzerland. This study’s aim is thus to provide a theory about the individual’s decision-making process regarding genetic testing for cancer predispositions in order to provide medical geneticists and genetic counsellors with insights into the needs and expectations of counsellees. We interviewed at-risk individuals who underwent genetic counselling in a clinical setting in Switzerland, using a grounded theory approach. Based on the interview data, we propose that a control-fate continuum, which is part of the individuals’ life philosophy, importantly influences the decision-making process. Those in need for control decide differently compared with those leaving their future to fate. Several psychosocial factors influence the position on the control-fate continuum: “looking for certainty”; “anticipating consequences”; “being socially influenced”; “simplifying risks”; and “deciding intuitively vs reflectively”. The control-fate continuum theory gives insights into the possible reasons behind decision-making regarding genetic testing for cancer predispositions. It includes both acceptors and decliners of genetic testing. Our theory helps healthcare professionals offering genetic counselling to anticipate problems within at-risk families and adapting their services to people’s needs.

癌症易感性的基因检测决策本质上是复杂的。了解决策过程的机制和影响因素对于遗传咨询至关重要，但瑞士尚未对此进行调查。因此，本研究的目的是提供一个关于个人关于癌症易感性基因检测的决策过程的理论，以便为医学遗传学家和遗传咨询师提供对被咨询者需求和期望的洞察。我们使用扎根理论方法采访了在瑞士临床环境中接受遗传咨询的高危个体。根据访谈数据，我们提出作为个人生活哲学一部分的控制-命运连续体对决策过程产生重要影响。与那些将未来交由命运的人相比，需要控制的人做出的决定是不同的。几个心理社会因素会影响控制-命运连续体的位置：“寻找确定性”；“预期后果”；“受到社会影响”；“简化风险”；和“凭直觉决定还是反思决定”。控制-命运连续体理论提供了有关癌症易感性基因检测决策背后的可能原因的见解。它包括基因检测的接受者和拒绝者。我们的理论帮助医疗保健专业人员提供遗传咨询，以预测高危家庭中的问题，并根据人们的需求调整他们的服务。“寻找确定性”；“预期后果”；“受到社会影响”；“简化风险”；和“凭直觉决定还是反思决定”。控制-命运连续体理论提供了有关癌症易感性基因检测决策背后的可能原因的见解。它包括基因检测的接受者和拒绝者。我们的理论帮助医疗保健专业人员提供遗传咨询，以预测高危家庭中的问题，并根据人们的需求调整他们的服务。“寻找确定性”；“预期后果”；“受到社会影响”；“简化风险”；和“凭直觉决定还是反思决定”。控制-命运连续体理论提供了有关癌症易感性基因检测决策背后的可能原因的见解。它包括基因检测的接受者和拒绝者。我们的理论帮助医疗保健专业人员提供遗传咨询，以预测高危家庭中的问题，并根据人们的需求调整他们的服务。它包括基因检测的接受者和拒绝者。我们的理论帮助医疗保健专业人员提供遗传咨询，以预测高危家庭中的问题，并根据人们的需求调整他们的服务。它包括基因检测的接受者和拒绝者。我们的理论帮助医疗保健专业人员提供遗传咨询，以预测高危家庭中的问题，并根据人们的需求调整他们的服务。