Cancer Control Research
5R03CA070669-02
Smith, Ken R.
ADVERSE SELECTION, LIFE INSURANCE, AND GENETIC TESTING
AbstractDESCRIPTION: (Applicant's Abstract) This study will analyze how
knowledge of genetic test results for the BRCA1 gene influences consumer
behaviors and attitudes regarding life insurance coverage. The current
proposal complements a larger, on-going research project, "Behavioral
and Psychosocial Effects of BRCA1 Testing," (R01-CA- 63681), that focuses
on psychological, familial, and risk behavior changes associated with
the receipt of genetic test results. The current study will look
specifically at how the receipt of genetic test results for the BRCA1
gene affects choices about life insurance coverage and consumers'
attitudes regarding if insurers should have access to genetic test
results. Particular attention will be given to assessing the potential
for adverse selection that is created by such genetic testing
procedures. The research specific questions that will be addressed are:
(1) Does the receipt of information that one is a BRCA1 gene carrier
lead women to increase their life insurance coverage above levels of
coverage purchased by (a) women who test negative for the BRCA1 gene,
(b) women who have a known family history of breast/ovarian cancer but
who are not tested, and/or (c) women in the general public who have no
family history of breast/ovarian cancer? (2) Are those who test negative
for the BRCA1 gene more likely to share their test results voluntarily
with insurers than those who test positive? (3) Do these four groups
differ in their opinions regarding the need to balance life, health, and
disability insurers' need to know the results of genetic tests and
consumers' right to privacy? Survey data on life insurance coverage and
attitudes will be gathered from four groups of women: (a) those who test
positive for the BRCA1 gene, (b) those who test negative for the BRCA1
gene, (c) those who have a family history of breast/ovarian cancer but
who are not tested for the BRCA1 gene, and (d) those who have no family
history of breast/ovarian cancer. A two-equation, multivariate system
that corrects for selectivity bias will be used to ascertain if
knowledge of genetic test results creates a threat of adverse selection
in the insurance market. Separate mulitvariate analyses will also
examine (a) the factors that affect the probability that consumers
voluntarily share test results with insurers, and (b) the factors that
affect public opinion regarding the consumer's right to privacy versus
the insurance industry's need to know genetic test results. The
findings of this study will provide information that is critical for the
conduct of human genetic research, the design of appropriate counseling
protocols, and the development of public policies that relate to the
possible use of genetic test results by the insurance industry.
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