ArticleJournal of genetic counseling2019
Insurance coverage does not predict outcomes of genetic testing: The search for meaning in payer decisions for germline cancer tests.
Article in Journal of genetic counseling, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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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.
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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.
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Who cites it
10 citing papers in PubMed.
- Frequency of Genetic Testing Among Patients With Epithelial Ovarian, Fallopian Tube, and Peritoneal Cancers: A Strategy to Improve Compliance.International journal of genomics · 2025Article
- The Evolution of Genetic Testing from Focused Testing to Panel Testing and from Patient Focused to Population Testing: Are We There Yet?Clinics in colon and rectal surgery · 2024Review
- Novel hemizygous single-nucleotide duplication in RPGR in a patient with retinal dystrophy and sensorineural hearing loss.Molecular genetics & genomic medicine · 2024Article
- Clinical guideline variability in the diagnosis of hereditary hematopoietic malignancy syndromes.Leukemia & lymphoma · 2023Article
- Insurance denials and diagnostic rates in a pediatric genomic research cohort.Genetics in medicine : official journal of the American College of Medical Genetics · 2023Article
- Association between Health Insurance Type and Genetic Testing and/or Counseling for Breast and Ovarian Cancer.Journal of personalized medicine · 2022Article
- Genetic Testing and/or Counseling for Colorectal Cancer by Health Insurance Type.Journal of personalized medicine · 2022Article
- Outcomes of retesting in patients with previously uninformative cancer genetics evaluations.Familial cancer · 2022Article
- Self-rated family health history knowledge among All of Us program participants.Genetics in medicine : official journal of the American College of Medical Genetics · 2022Article
- Outcomes of prior authorization requests for genetic testing in outpatient pediatric genetics clinics.Genetics in medicine : official journal of the American College of Medical Genetics · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
In this work, we explore the results of germline cancer genetic tests in individuals whose insurance would not cover this testing. We enrolled 31 patients with a personal history of cancer whose health insurer denied coverage for a clinical germline cancer panel genetic test recommended by a medical genetics provider into a study providing exome sequencing and return of cancer-related results. Five participants (16%) had a pathogenic variant identified related to increased cancer risk. Three participants (10%) had a variant of uncertain significance (VUS) in a gene related to their cancer history. These rates are not significantly different than the 12% rate of pathogenic or likely pathogenic (P/LP) variants and VUS in 1,462 patients approved by insurance to have a similar clinical germline cancer test (p = .59 for P/LP variants; p = .87 for VUS; Shirts et al., Genet Med, 18:974, 2016). Health insurance guidelines may not meaningfully differentiate between patients with cancer who are likely to benefit from germline cancer genetic testing and those who will not. Failure to identify pathogenic variants in this research cohort would have led to suboptimal care. Strategic evaluation of current germline cancer genetic testing coverage policies is needed to appropriately deliver precision medicine.
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