06 Jun Potentially Lifesaving Genetic Testing After Cancer Diagnosis Underutilized
MedicalResearch.com Interview with:
Dr. Kurian
Allison W. Kurian, M.D., M.Sc.
Professor of Medicine and of Epidemiology and Population Health
Associate Chief, Division of Oncology
Co-Leader, Population Sciences Program, Stanford Cancer Institute
Director, Women’s Clinical Cancer Genetics Program
Stanford University School of Medicine
Stanford, CA 94305-5405
MedicalResearch.com: What is the background for this study? What types of cancers were in the study?
Response: Genetic testing for cancer risk is increasingly important after a cancer diagnosis, to inform use of targeted therapies, secondary cancer prevention approaches and cascade genetic testing of family members. However, very little is known about how genetic testing is used after a cancer diagnosis at the population level. We leveraged a very large population-based data resource, the Surveillance, Epidemiology and End Results (SEER) cancer registries of the states of California and Georgia, and linked data from these registries to clinical genetic testing results provided by the four major laboratories that provide such testing. We used this linked registry-genetic testing dataset to study adults (age >=20 years) diagnosed with all types of cancer in the states of Georgia and California from 2013-2019.
MedicalResearch.com: What are the main findings?
Response: We found that genetic testing is low at the population level: only 6.8% of cancer patients received genetic testing within two years after their cancer diagnosis. For several cancers in which 100% testing is recommended, testing fell far below that threshold: 50% for male breast cancer, 39% for ovarian cancer, 6% for pancreatic cancer. We found significant and persistent racial and ethnic disparities, with Asian, Black and Hispanic patients less often tested than non-Hispanic White patients. Asian, Black and Hispanic patients were also more likely than non-Hispanic White patients to receive uncertain results of genetic testing.
MedicalResearch.com: What should readers take away from your report?
Response: There are gaps in integration of germline genetic testing into cancer care, which affect Asian, Black and Hispanic patients more than non-Hispanic White patients. When patients do not receive the genetic testing that guidelines recommend, they may miss the opportunity to receive targeted therapies that can be lifesaving. Addressing these gaps in genetic testing should be a priority for research and patient care.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: Innovative strategies for delivery of germline genetic testing after a cancer diagnosis should be tested and implemented: these include approaches such as integrating genetic counseling and testing into cancer treatment visits, telemedicine to extend the reach of the genetic counselor workforce, and prompts in electronic health records.
No disclosures
Citation:
Kurian AWAbrahamse PFurgal A, et al. Germline Genetic Testing After Cancer Diagnosis. JAMA. Published online June 05, 2023. doi:10.1001/jama.2023.9526
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