Potentially life-saving genetic testing after cancer diagnosis underused

MedicalResearch.com Interview with:

Allison W. Kurian, MD, M.Sc.Professor of Medicine and of Epidemiology and Population Health Associate Chief, Division of Oncology Co-Leader, Population Sciences Program, Stanford Cancer Institute Director, Womens Clinical Cancer Genetics Program Stanford University School of Medicine Stanford, CA 94305-5405

Doctor Kurian

Allison W. Kurian, MD, M.Sc.
Professor of Medicine and of Epidemiology and Population Health
Associate Chief, Division of Oncology
Co-director, Population Sciences Program, Stanford Cancer Institute
Director, Female Clinical Cancer Genetics Program
Stanford University School of Medicine
Stanford, Calif. 94305-5405

MedicalResearch.com: What is the background of this study? What types of tumors were in the study?

Answer: Genetic testing for cancer risk is increasingly important following a cancer diagnosis, to inform the use of targeted therapies, secondary cancer prevention approaches, and cascade genetic testing of family members. However, very little is known about how genetic testing is used after a population-level cancer diagnosis. We leveraged a very large population-based data resource, the California and Georgia State Cancer Surveillance, Epidemiology, and Outcomes (SEER) registries, and linked data from these registries to clinical genetic testing results provided by the four major laboratories that provide such a test. We used this linked registry genetic testing dataset to study adults (age >= 20 years) diagnosed with all types of cancer in the states of Georgia and California from 2013 to 2019.

MedicalResearch.com: What are the main findings?

Answer: We found that genetic testing is low at the population level: Only 6.8% of cancer patients received genetic testing within two years of being diagnosed with cancer. For several cancers where 100% testing is recommended, testing fell far below that threshold: 50% for male breast cancer, 39% for ovarian cancer, 6% for pancreas. We found significant and persistent racial and ethnic disparities, with Asian, Black, and Hispanic patients tested less often than non-Hispanic white patients. Asian, black, and Hispanic patients were also more likely than non-Hispanic white patients to receive equivocal genetic test results.

MedicalResearch.com: What should readers understand from your report?

Answer: There are gaps in integrating germline genetic testing into cancer care, affecting Asian, Black, and Hispanic patients more than non-Hispanic white patients. When patients do not receive guideline-recommended genetic testing, they may miss out on the opportunity to receive targeted therapies that can save their lives. Addressing these gaps in genetic testing should be a priority for research and patient care.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer: Innovative strategies for the delivery of germline genetic testing following a cancer diagnosis should be tested and implemented: these include approaches such as integrating genetic counseling and testing into cancer treatment visits, telehealth to extend the reach of the genetic counselor’s workforce and tips in electronic health records.

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Kurian AW, Abramse P, Furgal A, et al. Germline genetic testing after cancer diagnosis. JAMA. Published online June 05, 2023. doi:10.1001/jama.2023.9526

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