Shifts and Transpositions: An Analysis of Gateway Documents for Cancer Genetic Testing

Abstract

This study describes and analyzes a sample of noncommercial web pages that address cancer genetic testing. These “gateway documents,” which were returned in an initial Internet search for information, may serve as the only texts that peo­ple read when deciding whether to pursue genetic testing. Deliberative rhetorical theory elaborated into dimensions of embodied knowledge and scientific knowl­edge was mapped onto problematic integration theory to create a framework for investigating the documents. Analysis reveals the contingent nature of evaluating probability in genetic testing and the intrinsic need to examine the rhetorical con­struction of gateway documents as multidimensional communication events in which disadvantages and benefits shift—and sometimes transpose—according to the embodied knowledge of each person. Benefits and disadvantages of genetic test­ing become topoi that healthcare providers should consider carefully to improve the decision-making information offered to people who are searching for online resources.