Cancer Genetic Risk Assessment (CGRA) Certification: Experience from the First Five Years

Integrating cancer genetics, genomics and cancer risk assessment has become increasingly relevant to the care of patients and there is a need for clinicians across the spectrum of practice settings to acquire and demonstrate knowledge and competency in cancer genetics and risk assessment. National Consortium of Breast Centers (NCBC's) Certification Program in Cancer Genetics Risk Assessment (CGRA) is a voluntary, nationally accredited, examination-based certification program created to provide the assurance that healthcare providers with certification in CGRA possess the knowledge, skills and competency to provide cancer risk assessment services to patients and families. NCBC's CGRA certification was developed by a multidisciplinary committee of dedicated breast care, oncology, and cancer genetics professionals and approved by NCBC's board of trustees. Testing first became available in May 2020 with testing opportunities provided throughout the year. Testing options include both remote and in-person examination. The target audiences for certification are physicians, advanced practice nurses, physician assistants, and other skilled health care practitioners who care for at-risk unaffected and affected patients and their families.

A retrospective cohort of CGRA examination takers was collected from May 2020 (start of examination availability) through December 2024. Analyzed data includes: total number of examination takers, pass/fail rates, and professional background and practice setting of passing cohort. Descriptive statistics were used for analysis.

2020-2024. Total number of CGRA examination takers: 212 Total number (percent) passed: 187/212 (88.2%); failed: 25/212 (11.8%) Professional background of CGRA certificants: APP - 123/187 (65.8%) MD - 25/187 (13.4%) Other (RN/RT) - 39/187 (20.9%) RN: 34/187 (18.2%); RT: 5/187 (2.7%) Practice focus of CGRA certificants: Breast Center - 12/187 (6.4%) Gynecology - 14/187 (7.5%) High Risk/Genetics - 16/187 (8.6%) Oncology - 115/187 (61.5%) Primary Care - 1/187 (0.5%) Radiology - 4/187 (2.1%) Surgery - 25/187 (13.4%).

During the first 5 years of CGRA certification eligibility, a notable number of healthcare providers and other healthcare professionals have sought and obtained certification in cancer genetic risk assessment through NCBC's CGRA certification program. The largest percentage of certificant holders are APPs, followed by other healthcare professionals (RNs and RTs), and physicians. The most prominent practice setting for certificant holders is oncology, with many other specialty practice settings represented, including the screening and preventive care spaces. In conclusion, the CGRA certification is a sought-after credential appealing to a broad group of healthcare providers/professionals across practice disciplines allowing for a diverse patient population to obtain cancer genetic and risk assessment-related care. It is anticipated that there will be continued provider interest to attain certification in this rapidly expanding field, particularly with recognition of CGRA by several nationally recognized accrediting bodies.