4.4 Article

Current attitudes and preconceptions towards expanded carrier screening in the Eastern Chinese reproductive-aged population

Journal

JOURNAL OF ASSISTED REPRODUCTION AND GENETICS
Volume 38, Issue 3, Pages 697-707

Publisher

SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10815-020-02032-w

Keywords

Expanded carrier screening; Attitudes; Preconception; Misconceptions; Questionnaire

Funding

  1. National Key R&D Program of China [2018YFC1002402]
  2. National Natural Science Foundation of China [81770236, 81971398, 81801373, 81801445]
  3. Natural Science Foundation of Jiangsu Province [BK20181121]
  4. Scientific Research Project of Jiangsu Maternal and Child Health Association [FYX202008]

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Overall, the reproductive-aged population in Eastern China showed positive attitudes towards ECS, but there were some misconceptions about ECS and genetic diseases. Participants who showed initial interest, had prior awareness, or perceived benefits were more likely to intend to undergo ECS. Those with a bachelor's degree or above, or with a household income over 150,000 CNY, were more likely to pay ≥ 1000 CNY for the test.
Purpose A growing number of Chinese individuals of reproductive age will face the choice of accepting or refusing expanded carrier screening (ECS). This study aimed to explore the awareness, wishes, and possible misconceptions of ECS among this population, as well as factors affecting their decision-making. Methods Chinese reproductive-aged individuals in Eastern China who sought cell-free fetal DNA screening and peripheral blood karyotype were invited to complete a 31-item ECS survey by scanning a specific quick response code. We evaluated the relationship between awareness, attitudes, and intentions to participate in ECS, along with possible misconceptions. Results Overall, 93.1% of participants intended to undergo ECS at their expenses, and 53.6% indicated they would pay less than 1000 CNY (approximately 145 USD) for the test. Around 96.5% of participants had misconceptions about ECS and genetic diseases. Participants whose first reaction was interest, who had prior awareness of the test, or who perceived benefits were more likely to intend to use ECS (p < 0.001). Participants with a bachelor's degree or above or with a household income over 150,000 CNY (approximately 21,700 USD) would be more likely to pay >= 1000 CNY (p < 0.05). Conclusions Our study indicates that overall, the Eastern Chinese reproductive-aged population has positive attitudes towards ECS, although there are some misconceptions about ECS and genetic disorders. Population-based ECS appears to be desired by the reproductive-aged people in Eastern China. Steps should be taken to offer ECS along with pre- and post-test education and genetic counseling to raise awareness and to reduce misconceptions.

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