Implementation of a Traceback Testing Program for Ovarian Cancer: Findings from the FACTS Study

Area of Science:

• Genetics
• Oncology
• Public Health

Background:

• Traceback testing identifies individuals with prior cancer diagnoses who missed current genetic testing.
• This approach aims to benefit both patients and their at-risk relatives by uncovering hereditary cancer predispositions.
• Previous genetic testing may not have been standard or accessible for all patients with cancer history.

Purpose of the Study:

• To evaluate the implementation of a Traceback program in three US health systems.
• To assess the reach, fidelity, effectiveness, and acceptability of the Traceback program.
• To determine the feasibility and potential benefits of identifying and testing previously untested individuals with cancer history.

Main Methods:

• A multisite, nonrandomized pilot implementation study was conducted.
• Quantitative and qualitative methods were used to assess program outcomes.
• Eligible individuals were identified via administrative data and chart review, followed by outreach and genetic testing.

Main Results:

• 597 individuals were identified as eligible, with 59% successfully contacted.
• 133 individuals completed Traceback genetic testing, and 8% received pathogenic or likely pathogenic results.
• No relatives underwent cascade testing, despite 90% of positive results indicating its need; 36 individuals received variants of uncertain significance (VUS).

Conclusions:

• Traceback programs demonstrated high participant and implementer acceptability and applicability to other genetic screening conditions.
• Despite positive genetic results, cascade testing for relatives was not achieved in this pilot.
• Further study is warranted to explore the benefits and sustainability of Traceback programs, particularly regarding resource allocation for identifying eligible individuals.