Factors Affecting Genomic Testing in Prostate Cancer: Results From the Decision-Making, Experience, and Confidence In Determining Genomic Evaluation (DECIDE) Survey

Abstract

PURPOSE Genomic testing for prostate cancer (PCa) clinical management and hereditary cancer assessment has grown in clinical impact; however, challenges remain regarding optimal implementation and end-user confidence. The Decision-making, Experience, and Confidence In Determining Genomic Evaluation (DECIDE) survey was designed to collect information regarding utility and understanding of genomic testing from PCa health care providers, researchers, and stakeholders. METHODS The DECIDE survey was administered online from October 2022 to January 2023 with 18 multiple-response questions. Survey domains included self-confidence with ordering and interpreting germline and somatic genomic tests, process of testing and use of results, decision-making factors, and barriers to testing. Data were summarized by evaluating counts and percentages of responses, and the results were presented by descriptive statistics. RESULTS One hundred twenty-two participants completed the survey. The majority were medical oncologists (70%) and at academic medical centers (89%). Self-confidence was high in knowing indications for genomic testing (82% respondents) but lower in interpretation of results, especially from circulating tumor DNA (52%). Confidence varied in interpreting pathogenic variants (65% high confidence), variants of unknown