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Improving Genetic Testing Uptake in Prostate Cancer: Outcomes From a Multidisciplinary Clinic Evaluation.

Laura S Graham1, Aditya Mantha2, Chiagozie Paul-Onyia2

  • 1Division of Medical Oncology, Department of Internal Medicine, University of Colorado Anschutz Medical Center, Aurora, CO.

JCO Oncology Practice
|May 28, 2026
PubMed
Summary

A new mainstream genetic testing model significantly boosted prostate cancer genetic testing completion rates. This integrated approach improves access to precision oncology and hereditary cancer risk assessment.

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Area of Science:

  • Urologic Oncology
  • Cancer Genetics
  • Quality Improvement Initiatives

Background:

  • National Comprehensive Cancer Network guidelines recommend germline genetic testing for prostate cancer patients with high-risk features or family history.
  • Traditional referral-based models often result in low genetic testing uptake.
  • The University of Colorado Urological Oncology Multidisciplinary Clinic (MDC) aimed to improve testing rates.

Purpose of the Study:

  • To assess the impact of transitioning to a mainstream genetic testing model on testing uptake and genetic counseling completion.
  • To compare a provider-initiated mainstream model with a traditional referral-based model.

Main Methods:

  • A quality improvement initiative was implemented in 2024, transitioning from a referral-based to a mainstream genetic testing model.
  • Patients with prostate cancer evaluated at the urologic oncology MDC in 2023 (referral-based) were compared with eligible patients in 2024 (mainstream model).
  • Genetic testing completion rates and subsequent genetic counseling uptake were analyzed.

Main Results:

  • Genetic testing completion increased significantly from 30% in 2023 to 72% in 2024 (P < .001).
  • Pathogenic variants were identified in 12% of patients tested under the mainstream model.
  • Seven of 10 patients with pathogenic variants completed post-test genetic counseling, discussing cascade testing and preventive screening.

Conclusions:

  • A provider-initiated, mainstream genetic testing model significantly improved pretest genetic testing completion rates in a multidisciplinary prostate cancer clinic.
  • This integrated approach enhances care coordination and expedites genetic evaluation.
  • The model offers a scalable framework for expanding precision oncology and hereditary cancer risk assessment in prostate cancer management.