Merging Nature and Nurture: Factors Influencing Genetic Counselors' Discussions of Lifestyle-Based Cancer Prevention Strategies
Anja Hall
Co-Presenters: Individual Presentation
College: College of Health Professions and Human Services
Major: MS.GENTICOUNSLNG
Faculty Research Mentor: Pervola, Josie
Abstract:
Introduction:Lifestyle behaviors such as diet, physical activity, body weight, tobacco use, and alcohol consumption account for a substantial proportion of cancer incidence and mortality. Adhering to evidence-based lifestyle guidelines reduces cancer risk and improves survival for individuals with and without hereditary cancer predisposition. However, lifestyle-based cancer prevention is inconsistently discussed during cancer genetic counseling.Purpose:This study examines how genetic counselors’ familiarity with the American Cancer Society (ACS) Guideline for Diet and Physical Activity, personal lifestyle practices, beliefs about lifestyle and cancer prevention, and professional training influence the frequency of lifestyle counseling and perceived barriers to integrating this content into sessions.Methods:A mixed-method design was employed using an anonymous electronic survey of board-certified/-eligible cancer genetic counselors, supplemented by semi-structured virtual interviews with eight survey respondents. Descriptive statistics and t-tests assessed reported behavioral frequencies and agreement with statements. Thematic analysis using an inductive coding approach was used to analyze interview data.Results:Participants were significantly more likely to discuss medical prevention strategies compared to lifestyle-based prevention (p<0.001). Alcohol and tobacco use were discussed more often than diet (p<0.001), exercise (p<0.001), or body weight (p<0.001), with body weight addressed least frequently (p<0.001). A small positive association was observed between counselors’ personal lifestyle habits and likelihood to counsel on specific factors, with significance for eating a plant- and fiber-rich diet (p<0.01) and limiting red/processed meat intake (p<0.01). Participant interviews identified five major themes: discretion in discussing lifestyle, concern for rapport, positive patient reactions, lack of time, and education/experience affecting confidence.Conclusions:These findings show that lifestyle-based cancer prevention is addressed less consistently than medical strategies despite strong evidence supporting its role in risk reduction. Qualitative insights highlight practical and perceptual barriers- including time constraints, limited training, and fear of stigma- contributing to variability in counselor comfort and discussion frequency. Increased professional guidance and targeted education may help address these barriers and promote consistent integration of preventative lifestyle strategies into routine care. This study establishes a foundation for addressing the research gap surrounding the state of patient education on lifestyle-based prevention in cancer genetic counseling.Keywords: Genetic counseling, lifestyle factors, cancer prevention