Screening for genomic predisposition to diseases of adulthood is emerging in standard medical practice. Breast cancer predisposition testing provides a useful example for understanding the potential implications of risk-related screening in practice. Risk is an important and complex psychological construct that is understood differently both between scientific disciplines and between medical and lay persons. The process of establishing thresholds for classifying whether one's risk reaches levels warranting departure from standard preventive strategies is an important predictor of both physician feedback and patient interpretation of their risk. Messages about genomic breast cancer risk arising during the pedigree screening context are conveyed via explicit and implicit modes of communication. Best practices for communicating about genomic risk and the implications for health disparities related to screening for genomic susceptibility remain unknown. More work is urgently needed given the societal forces that are catalyzing population-based screening for genomic predisposition into the routine practice of preventive medicine.
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