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Omitting genetic counseling in remote cancer risk assessment did not increase participant distress. This study suggests an alternative care model for genetic testing, improving accessibility.

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Area of Science:

  • Genetics
  • Oncology
  • Psychology

Background:

  • Personalized genetic counseling can be a barrier to cancer risk assessment.
  • The impact of omitting genetic counseling on participant distress during remote testing is not well understood.

Purpose of the Study:

  • To evaluate if omitting pretest and/or posttest genetic counseling increases distress during remote cancer genetic testing.
  • To explore alternative models for genetic risk assessment.

Main Methods:

  • The Making Genetic Testing Accessible (MAGENTA) trial was a 4-arm randomized noninferiority study.
  • Participants (n=3839) were women aged 30+ with a family history of cancer or a known pathogenic variant (PV) in their family.
  • The study compared distress levels at 3 months between groups receiving standard counseling and those with omitted pretest and/or posttest counseling.

Main Results:

  • Omitting pretest counseling for all participants and posttest counseling for those without a PV was noninferior for distress at 3 months in the family history cohort.
  • No significant differences in anxiety, depression, or decisional regret were observed at 3 months.
  • Completion rates for genetic testing were highest in arms without pretest counseling.

Conclusions:

  • Omitting individualized pretest genetic counseling for all participants and posttest counseling for those without a pathogenic variant is a viable alternative care model for remote genetic testing.
  • This approach does not increase participant distress and may improve testing completion rates.
  • Findings support expanding access to cancer genetic risk assessment through streamlined counseling protocols.