Site Editor
Joyce F. Liu, MD, MPH
Joyce F. Liu, MD, MPH
Posted: Monday, March 17, 2025
Genetic testing can be a key aspect in the management of ovarian cancer and endometrial cancer, but multiple barriers often prevent patients from benefiting from these tests. In a recent study published in JCO Precision Oncology, Ying L. Liu, MPH, MD, of Memorial Sloan Kettering Cancer Center (MSK), New York, and colleagues outlined the successes and challenges of integrating such testing into routine oncologic care.
“We demonstrate very high germline genetic testing rates using a mainstreaming model of paired tumor-normal sequencing in our gynecologic oncology clinics for patients with ovarian cancer and endometrial cancer,” Dr Liu and colleagues noted in the study.
This quality improvement study evaluated the genetic testing process at MSK. Their approach incorporated genetic testing within oncology clinics rather than through separate genetic counseling services, to improve uptake and streamline workflows. Between February and April 2023, the researchers tracked 116 newly diagnosed patients with ovarian cancer and endometrial cancer. Genetic testing was initiated at the point of oncologic care using the MSK-IMPACT targeted sequencing assay.
A total of 91% of those with ovarian cancer and 75% of those with endometrial cancer completed genetic testing. In almost every case, the test results were available within 3 months. Still, the study also identified barriers that prevented some patients from being tested. The most common reason for missed testing was the absence of genetic testing recommendations from the clinical team. Additionally, some patients felt overwhelmed at their initial visit and opted out, financial and privacy concerns also contributed to nonparticipation, and language barriers were noted, even though multilingual consent options were available.
In addition, genetic testing was often discussed only at the initial visit, and so opportunities were missed for follow-up conversations when patients may be more receptive. Thus, the authors proposed implementing multiple touchpoints for genetic testing discussions throughout the treatment timeline; creating digital, self-directed consent tools to allow patients to initiate testing on their own; and improving coordination between surgical and medical oncology teams to ensure genetic testing is recommended consistently.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
