ArticleBMC health services research2018
Impact of a genetic counseling requirement prior to genetic testing.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04533555 (Randomized Trial of Universal vs. Guideline-directed Germline Testing Among Young Adults With Cancer), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Trial of Universal vs. Guideline-directed Germline Testing Among Young Adults With Cancer
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Delivering genomic medicine in the United Kingdom National Health Service: a systematic review and narrative synthesis.Genetics in medicine : official journal of the American College of Medical Genetics · 2019Pooled it
- Improving Uptake of Cancer Genetic Risk Assessment in a Remote Tailored Risk Communication and Navigation Intervention: Large Effect Size but Room to Grow.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Exploring willingness to pay out-of-pocket for genetic testing among ovarian cancer patients in Malaysia, a middle-income country in Asia.Journal of gynecologic oncology · 2026Observational
- Review
- Development and Real-World Evaluation of a Statewide Mainstream Model of Germline Genetic Testing for BRCA1/2 and Mismatch Repair Gene Variants (Lynch Syndrome).Asia-Pacific journal of clinical oncology · 2026Article
- Turkish men's experiences of positive SMA carrier results: a qualitative study within a gendered screening framework.BMC public health · 2025Article
- Religious factors predict support for genomic medicine more strongly than politics, education, or trust: A survey of 4,939 adults in the United States.Frontiers in genetics · 2025Article
- Enhancing Clinical Infrastructure for the Delivery of Intrathecal and Genetic Therapies: A Qalsody (Tofersen) Model for Patients WithNeurology. Clinical practice · 2024Article
- Hereditary Cancer Clinics Improve Adherence to NCCN Germline Testing Guidelines for Pancreatic Cancer.Journal of the National Comprehensive Cancer Network : JNCCN · 2024Article
- Adherence to NCCN Genetic Testing Guidelines in Pancreatic Cancer and Impact on Treatment.The oncologist · 2023Article
- The Role of the Surgeon in the Germline Testing of the Newly Diagnosed Breast Cancer Patient.Current oncology (Toronto, Ont.) · 2023Review
- Article
- Mainstreaming germline genetic testing for patients with pancreatic cancer increases uptake.Familial cancer · 2023Article
- Addressing the routine failure to clinically identify monogenic cases of common disease.Genome medicine · 2022Review
- An overview of genetic services delivery for hereditary breast cancer.Breast cancer research and treatment · 2022Review
- Influence of payer coverage and out-of-pocket costs on ordering of NGS panel tests for hereditary cancer in diverse settings.Journal of genetic counseling · 2022Article
- The Knowledge and Attitude of Patients Diagnosed with Epithelial Ovarian Cancer towards Genetic Testing.International journal of environmental research and public health · 2021Article
- Disparities in Genetic Testing and Care among Black women with Hereditary Breast Cancer.Current breast cancer reports · 2020Article
- Disparities in BRCA counseling across providers in a diverse population of young breast cancer survivors.Genetics in medicine : official journal of the American College of Medical Genetics · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGenetic counseling by a Genetic Counselor (GC) is a requirement prior to genetic testing for cancer susceptibility genes (GC-mandate policy) for some insurers. This study evaluated the impact of this policy from the patient perspective.
methodsSurveys were sent to individuals for whom their insurer ordered genetic testing for the cancer susceptibility genes BCRA1 and BRCA2 over a 1 year time period that spanned the introduction of a GC-mandate policy. Responses were assessed by time period (before/after policy introduction) and genetic test completion.
resultsThe surveys were completed by 1247/4950 (25.7%) eligible individuals. After policy introduction, there was no change in the proportion of respondents who completed genetic testing (p = 0.13) or had a mutation (p = 0.55). Overall decisional conflict (uncertainty or feeling uninformed) around genetic testing did not change after policy introduction (p = 0.16), but was significantly higher among respondents who did not complete genetic testing (p < 0.01). Although a larger proportion of respondents saw a GC after policy introduction (p < 0.01), fewer did so to better understand their test results (p < 0.01). The proportion of respondents who did not see a GC due to insurance issues/requirements and time restraints was higher among those tested after policy introduction or who did not complete genetic testing (p < 0.01). In multivariate analysis, respondents with a household income of $25,000 or greater were 3-times more likely to complete testing.
conclusionsA GC-mandate policy did not improve decisional conflict or increase the number of deleterious mutations identified and low-income respondents were less likely to complete testing. On the contrary, insurance requirements and time constraints may be preventing individuals at risk from receiving appropriate testing.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.