Date of Award

Spring 2026

Document Type

Open Access Thesis

Department

Genetic Counseling

First Advisor

Amy Wardyn

Abstract

Appalachian Kentucky has the highest cancer incidence in the United States and about 5-10% of all cancer has a hereditary cause. Despite this, there are no board- certified genetic counselors located in the area, and few genomic studies have been done in this population. This study aimed to define Appalachian Kentuckians’ interest in cancer genetic counseling and knowledge of cancer risk factors. An original online survey including multiple choice, Likert scale, and open response items was utilized to assess interest in pursuing cancer genetic counseling and how knowledge of cancer causes impacts interest in cancer genetic counseling. A total of 446 responses were analyzed using Chi-square analysis to investigate barriers that limit cancer knowledge and affect genetic counseling interest in the Appalachian Kentucky population. Most participants felt that family history (81.6%) and smoking (92.6%) increased cancer risk the most of the five factors included. Statistically significant factors predicting interest in cancer genetic counseling were family history of cancer under 50 years (p = 0.003), belief that family history increases cancer risk (p = 0.0002), and belief that they are at a higher risk to develop cancer than the general population (p = 0.002). Factors that were not significant for interest included education level and age. Most participants displayed prior knowledge of basic genetic concepts and what a cancer genetic counselor does, so most showed no change in interest after reading the description (73.4%). Individuals that were not interested cited old age, lack of family history, and cost or insurance barriers as reasons for lack of interest. These findings showed that Appalachian Kentuckians are  knowledgeable about important cancer risk factors and understand that cancer genetic counseling is most appropriate for individuals with family history. There were no unique knowledge or cultural barriers to implementing cancer genetic counseling in this population, and there is interest in local access to this service.

Rights

© 2026, Ashton Farmer

Download

Share

COinS