Prevalence of clinician-ordered genetic testing in rural and urban United States counties: An analysis of the 2022 Health Information National Trends Survey

Objective: Rural residents face challenges to realizing guideline-concordant healthcare. Less is known about the role of rurality in achieving guideline-concordant genetic testing. To address this gap, we estimated the association between rural residence and two types of clinician-ordered genetic te...

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Main Authors: Anne C. Madeo, Erin D. Bouldin, Kimberly A. Kaphingst, Chelsey R. Schlechter, Melissa Yack, Jennie L. Hill
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Preventive Medicine Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2211335525002025
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author Anne C. Madeo
Erin D. Bouldin
Kimberly A. Kaphingst
Chelsey R. Schlechter
Melissa Yack
Jennie L. Hill
author_facet Anne C. Madeo
Erin D. Bouldin
Kimberly A. Kaphingst
Chelsey R. Schlechter
Melissa Yack
Jennie L. Hill
author_sort Anne C. Madeo
collection DOAJ
description Objective: Rural residents face challenges to realizing guideline-concordant healthcare. Less is known about the role of rurality in achieving guideline-concordant genetic testing. To address this gap, we estimated the association between rural residence and two types of clinician-ordered genetic testing among individuals who had heard of genetic testing. Methods: In 2024, we considered the 4559 individuals (80.0 % of respondents) who indicated that they had heard of genetic testing in the cross-sectional Health Information National Trends Survey wave 6, collected in the United States, March 7 – November 8, 2022, to assess the association between rurality and two types of clinician-ordered genetic testing, reproductive carrier and disease risk testing. Log binomial regression models estimated the prevalence ratios of two types of guideline-concordant clinician-ordered genetic testing while adjusting for sociodemographic characteristics. Results: Of the 4559 respondents assessed for eligibility, 976 and 3933 responses were eligible for analysis of clinician-ordered reproductive genetic carrier testing and disease risk testing, respectively. The prevalence of clinician-ordered reproductive carrier and disease risk genetic testing did not vary by rurality in adjusted multivariable regression analyses (adjusted prevalence ratio (aPR): 0.71, 95 % CI 0.38–1.33, aPR: 1.23, 95 % CI 0.86–1.75, respectively). Post hoc we identified significant differences in different covariate aPRs in both types of clinician-ordered genetic testing. Conclusions: Clinician-ordered genetic testing does not appear to be associated with geography among individuals who have heard of genetic testing. Post hoc differences in factors associated with each type of testing suggest pathways by which the differences in use may occur.
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spelling doaj-art-d752cb382dd94a16a784ce7e0ae3277e2025-08-23T04:48:05ZengElsevierPreventive Medicine Reports2211-33552025-09-015710316310.1016/j.pmedr.2025.103163Prevalence of clinician-ordered genetic testing in rural and urban United States counties: An analysis of the 2022 Health Information National Trends SurveyAnne C. Madeo0Erin D. Bouldin1Kimberly A. Kaphingst2Chelsey R. Schlechter3Melissa Yack4Jennie L. Hill5Department of Population Health Sciences, University of Utah, 295 Chipeta Way, Williams Building, Suite 16, University of Utah, Salt Lake City, UT 84108, USA; Corresponding author.Department of Internal Medicine, University of Utah School of Medicine, 30 N. Mario Capecchi Dr., 3rd Floor North, Salt Lake City, UT 84112, USA; IDEAS Center, George E. Wahlen Department of Veterans Affairs Medical Center, 500 Foothill Boulevard, Salt Lake City, UT 84148, USAHuntsman Cancer Institute, University of Utah, 1950 Circle of Hope Dr., Salt Lake City, UT 84112, USA; Department of Communication, University of Utah, Languages and Communications Building, 255 S. Central Campus Dr., Room 2400, Salt Lake City, UT 84112, USADepartment of Population Health Sciences, University of Utah, 295 Chipeta Way, Williams Building, Suite 16, University of Utah, Salt Lake City, UT 84108, USA; Huntsman Cancer Institute, University of Utah, 1950 Circle of Hope Dr., Salt Lake City, UT 84112, USAHuntsman Cancer Institute, University of Utah, 1950 Circle of Hope Dr., Salt Lake City, UT 84112, USADepartment of Population Health Sciences, University of Utah, 295 Chipeta Way, Williams Building, Suite 16, University of Utah, Salt Lake City, UT 84108, USAObjective: Rural residents face challenges to realizing guideline-concordant healthcare. Less is known about the role of rurality in achieving guideline-concordant genetic testing. To address this gap, we estimated the association between rural residence and two types of clinician-ordered genetic testing among individuals who had heard of genetic testing. Methods: In 2024, we considered the 4559 individuals (80.0 % of respondents) who indicated that they had heard of genetic testing in the cross-sectional Health Information National Trends Survey wave 6, collected in the United States, March 7 – November 8, 2022, to assess the association between rurality and two types of clinician-ordered genetic testing, reproductive carrier and disease risk testing. Log binomial regression models estimated the prevalence ratios of two types of guideline-concordant clinician-ordered genetic testing while adjusting for sociodemographic characteristics. Results: Of the 4559 respondents assessed for eligibility, 976 and 3933 responses were eligible for analysis of clinician-ordered reproductive genetic carrier testing and disease risk testing, respectively. The prevalence of clinician-ordered reproductive carrier and disease risk genetic testing did not vary by rurality in adjusted multivariable regression analyses (adjusted prevalence ratio (aPR): 0.71, 95 % CI 0.38–1.33, aPR: 1.23, 95 % CI 0.86–1.75, respectively). Post hoc we identified significant differences in different covariate aPRs in both types of clinician-ordered genetic testing. Conclusions: Clinician-ordered genetic testing does not appear to be associated with geography among individuals who have heard of genetic testing. Post hoc differences in factors associated with each type of testing suggest pathways by which the differences in use may occur.http://www.sciencedirect.com/science/article/pii/S2211335525002025Rural populationGenetic testingGeographyDisease susceptibilityGenetic carrier screeningSurveys and questionnaires.
spellingShingle Anne C. Madeo
Erin D. Bouldin
Kimberly A. Kaphingst
Chelsey R. Schlechter
Melissa Yack
Jennie L. Hill
Prevalence of clinician-ordered genetic testing in rural and urban United States counties: An analysis of the 2022 Health Information National Trends Survey
Preventive Medicine Reports
Rural population
Genetic testing
Geography
Disease susceptibility
Genetic carrier screening
Surveys and questionnaires.
title Prevalence of clinician-ordered genetic testing in rural and urban United States counties: An analysis of the 2022 Health Information National Trends Survey
title_full Prevalence of clinician-ordered genetic testing in rural and urban United States counties: An analysis of the 2022 Health Information National Trends Survey
title_fullStr Prevalence of clinician-ordered genetic testing in rural and urban United States counties: An analysis of the 2022 Health Information National Trends Survey
title_full_unstemmed Prevalence of clinician-ordered genetic testing in rural and urban United States counties: An analysis of the 2022 Health Information National Trends Survey
title_short Prevalence of clinician-ordered genetic testing in rural and urban United States counties: An analysis of the 2022 Health Information National Trends Survey
title_sort prevalence of clinician ordered genetic testing in rural and urban united states counties an analysis of the 2022 health information national trends survey
topic Rural population
Genetic testing
Geography
Disease susceptibility
Genetic carrier screening
Surveys and questionnaires.
url http://www.sciencedirect.com/science/article/pii/S2211335525002025
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