Clinician Recommendation for Hereditary Genetic Testing in Participants at Increased Risk for Hereditary Cancer

Area of Science:

• Medical Genetics
• Oncology
• Public Health

Background:

• Genetic testing (GT) is crucial for managing hereditary cancers but remains underutilized in clinical practice.
• Key barriers to GT uptake include knowledge gaps, cost, and inconsistent clinician recommendations.
• Clinician recommendation is a significant driver for patient uptake of genetic testing.

Purpose of the Study:

• To analyze factors associated with receiving a clinician recommendation for genetic testing (GT) among individuals with increased hereditary cancer risk.
• To identify demographic and clinical characteristics influencing the likelihood of a GT recommendation.

Main Methods:

• A survey was administered to 784 adult participants with personal or family history suggestive of hereditary cancer risk who had not undergone GT.
• Multivariable logistic regression analyzed associations between participant demographics, cancer history, and receipt of a clinician recommendation for GT.

Main Results:

• Only 14.0% of eligible participants reported receiving a clinician recommendation for GT.
• Lower recommendation rates were observed in younger adults, those without financial stress, and individuals with higher education levels.
• Multivariate analysis indicated that participants reporting no financial stress were less likely to receive a GT recommendation (p=0.049).

Conclusions:

• Significant disparities exist in clinician-led recommendations for genetic testing (GT).
• Enhanced clinician education on GT indications and implementation of decision support tools are needed.
• Systematic identification of patients with personal/family history meeting GT criteria is essential for equitable access.