Context: Research is limited regarding the potential of genetic testing for cancer risk in rural Appalachia. Purpose: This study examined perceptions of genetic testing in a population sample of Kentuckians, with a focus on Appalachian and rural differences. The goals were to examine cultural and psychosocial factors that may predict intentions to test for hereditary cancer, need for help with information seeking for decision making about genetic testing for hereditary cancer, and amount of help needed with information seeking for decision making about genetic testing for hereditary cancer in this population. Methods: Analysis of data from a general social survey of adults using random-digit dialing in Kentucky (N 882). Findings: An ordinal regression found that younger age, having a family history of cancer, and greater worry predicted greater intentions to seek genetic testing. A logistic regression found that having more education, excellent subjective knowledge of genetics, and less worry about cancer predicted less need for help in seeking information about testing. An ordinal regression found that less subjective knowledge of genetics and greater worry predicted greater amount of help needed. Conclusions: Additional counseling to explain limitations of genetic testing may be needed. Further, those with less knowledge about genetics and more worry about hereditary cancer may have greater need for help with information seeking for decision making, a need that may be further exacerbated by the lack of medical professionals, particularly genetic counselors, who may provide information about genetic testing in rural, Appalachian Kentucky.