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Predictors of patient uptake of colorectal cancer gene environment risk assessment

Michael J Hall1*, Sharon L Manne2, Ronald E Myers3, Eileen M Keenan1, Andrew M Balshem1 and David S Weinberg1

Author Affiliations

1 Cancer Prevention and Control, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19038, USA

2 Cancer Prevention and Control, Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901, USA

3 Department of Medical Oncology, Jefferson Medical College, 1025 Walnut Street, Philadelphia, PA 19107, USA

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Genome Medicine 2012, 4:92  doi:10.1186/gm393

Published: 29 November 2012



In an ongoing clinical trial, the genetic and environmental risk assessment (GERA) blood test offers subjects information about personal colorectal cancer risk through measurement of two novel low-to-moderate risk factors. We sought to examine predictors of uptake of the GERA blood test among participants randomized to the Intervention arm.


Primary care patients aged 50 to 74 years eligible for colorectal cancer screening are randomized to receive a mailed stool blood test kit to complete at home (Control) or to the control condition plus an in-office blood test called GERA that includes assessment of red blood cell folate and DNA-testing for two MTHFR (methylenetetrahydrofolate reductase) single nucleotide polymorphisms (SNPs) (Intervention). For the present study, baseline survey data are examined in participants randomized to the Intervention.


The first 351 intervention participants (161 African American/190 white) were identified. Overall, 249 (70.9%) completed GERA testing. Predictors of GERA uptake included race (African American race, odds ratio (OR) 0.51 (0.29 to 0.87)), and being more knowledgeable about GERA and colorectal cancer screening (OR 1.09 (1.01 to 1.18)). Being married (OR 1.81 (1.09 to 3.00)) was also significant in the multivariable model.


Participant uptake of GERA testing was high. GERA uptake varied, however, according to socio-demographic background and knowledge.