A new study published in JAMA Network Open evaluates methods to enhance cancer-gene testing in primary care clinics, emphasizing the potential for earlier detection of hereditary cancer risks.

The research compared two approaches for assessing hereditary cancer risks: a point-of-care questionnaire completed by patients during their clinic visit and a direct engagement method where patients filled out the questionnaire online at home.

Conducted across 12 clinics in Washington state and Montana/Wyoming, the study included a total of 95,623 patients, with 18,030 in the point-of-care group and 41,558 in the direct engagement group.

Results revealed that 19.1% of patients in the point-of-care approach completed the risk assessment, while only 8.7% did so in the direct engagement group.

Among those eligible for testing, 44.7% from the direct engagement group proceeded to get tested, compared to just 24.7% from the point-of-care group, indicating lower follow-through in the latter despite higher initial engagement.

Lead researcher Dr. Elizabeth Swisher pointed out that routine screening for cancer susceptibility genes is often neglected in primary care due to perceived complexities and the existing workload.

The study concludes that while both methods are useful, there is a critical need for strategies to improve testing uptake and reduce barriers to genetic testing in primary care.

Patients identified as potentially carrying cancer-susceptibility genes were offered a free saliva test screening for 29 genes, along with genetic counseling for those with identified risk variants.

Dr. Swisher noted that respondents in the direct engagement group may have had greater concerns about their genetic history, which could have influenced their likelihood to test positive for cancer risk genes.

The questionnaires used in the study asked about patients' personal and family cancer histories, as well as relevant ethnic backgrounds, particularly focusing on those with Ashkenazi Jewish ancestry linked to several cancer risks.