Introduction: Genomic tests can predict risk and tailor screening recommendations for colorectal cancer (CRC). Primary care could be suitable for their widespread implementation. Objective: We aimed to assess the feasibility and acceptability of administering a CRC genomic test in primary care. Methods: Participants aged 45–74 years recruited from 4 Australian general practices were offered a genomic CRC risk test. Participants received brief verbal information about the test comprising 45 CRC-associated single-nucleotide polymorphisms, before choosing whether to undertake the test. Personalized risks were given to testers. Uptake and knowledge of the genomic test, cancer-specific anxiety (Cancer Worry Scale), psychosocial impact (Multidimensional Impact of Cancer Risk Assessment [MICRA] score), and impact on CRC screening behaviour within 6 months were measured. Results: In 150 participants, test uptake was high (126, 84%), with 125 (83%) having good knowledge of the genomic test. Moderate risk participants were impacted more by the test (MICRA mean: 15.9) than average risk participants (mean: 9.5, difference in means: 6.4, 95% confidence interval (CI): 1.5, 11.2, p = 0.01), but all scores were low. Average risk participants’ cancer-specific anxiety decreased (mean differences from baseline: 1 month −0.5, 95% CI: −1.0, −0.1, p = 0.03; 6 months −0.6, 95% CI: −1.0, −0.2, p = 0.01). We found limited evidence for genomic testers being more likely to complete the risk-appropriate CRC screening than non-testers (41 vs. 17%, odds ratio = 3.4, 95% CI: 0.6, 34.8, p = 0.19), but some mediators of screening behaviour were altered in genomic testers. Conclusions: Genomic testing for CRC risk in primary care is acceptable and likely feasible. Further development of the risk assessment intervention could strengthen the impact on screening behaviour.

中文翻译：

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结直肠癌风险的基因组测试：这在初级保健中是否可接受和可行？

简介：基因组测试可以预测风险并定制结肠直肠癌 (CRC) 的筛查建议。初级保健可能适合它们的广泛实施。目标：我们旨在评估在初级保健中进行 CRC 基因组检测的可行性和可接受性。方法：从 4 个澳大利亚全科诊所招募的 45-74 岁参与者接受了基因组 CRC 风险测试。在选择是否进行测试之前，参与者收到了关于测试的简短口头信息，包括 45 个与 CRC 相关的单核苷酸多态性。为测试人员提供了个性化的风险。基因组测试、癌症特异性焦虑（癌症担忧量表）、社会心理影响（癌症风险评估的多维影响 [MICRA] 评分）的吸收和知识，并测量了对 6 个月内 CRC 筛查行为的影响。结果：在 150 名参与者中，测试接受率很高 (126, 84%)，其中 125 (83%) 对基因组测试有很好的了解。测试对中等风险参与者的影响（MICRA 平均值：15.9）比平均风险参与者（平均值：9.5，平均值差异：6.4，95% 置信区间 (CI)：1.5、11.2，p = 0.01）更大，但所有分数低。平均风险参与者的癌症特异性焦虑降低（与基线的平均差异：1 个月 -0.5，95% CI：-1.0，-0.1，p = 0.03；6 个月 -0.6，95% CI：-1.0，-0.2，p = 0.01）。我们发现基因组测试者比非测试者更有可能完成适合风险的 CRC 筛查的证据有限（41 对 17%，优势比 = 3.4，95% CI：0.6、34.8，p = 0.19），但在基因组测试者中，筛选行为的一些介质发生了改变。结论：初级保健中 CRC 风险的基因组检测是可以接受的并且可能是可行的。风险评估干预的进一步发展可以加强对筛查行为的影响。