Tolerance for ambiguity could influence awareness of breast cancer genetic testing and inform health education

Objective: This exploratory study assessed relationships among education, tolerance for ambiguity, and genetic testing awareness in light of implications for cancer genetics education. Methods: Cross-sectional analyses were conducted from self-administered written survey data of a breast cancer risk communication trial, including 899 Women's Health patients recruited from 2003 to 2005. The modifying effect of tolerance for ambiguity on the relationship between educational background and breast cancer genetic testing awareness was assessed through logistic regression. Results: There was a statistically significant main effect of education (p < 0.05), but not tolerance for ambiguity, on genetic testing awareness. However, the relationship between education and awareness was stronger among those with high tolerance for ambiguity (p for interaction <0.05), even when controlling for age, race, and breast cancer family history. Among persons with high (>1 SD above the mean) and medium tolerance for ambiguity, the relationship between education and awareness was positive and significant (p = 0.048 and 0.002, respectively). Among participants with low tolerance for ambiguity, the association was not significant. Conclusions: Educational background may predict awareness knowledge of breast cancer genetic testing only for those with higher tolerance for ambiguity. These findings could inform future intervention research concerning education about cancer genetic testing.