ArticleJournal of the National Comprehensive Cancer Network : JNCCN2023
Nationwide Trends and Determinants of Germline BRCA1/2 Testing in Patients With Breast and Ovarian Cancer.
Article in Journal of the National Comprehensive Cancer Network : JNCCN, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: ASCO Guideline Update.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Guideline
- Genetic Testing Uptake Among Patients With Newly Diagnosed Breast Cancer.JAMA network open · 2026Article
- Opportunities to improve detection of genetic predisposition for ovarian cancer applying the Tumor-First workflow.Familial cancer · 2026Article
- Rethinking ovarian cancer III: the past decade and future directions.Nature reviews. Cancer · 2026Review
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- BRCA1 and BRCA2 carriers: Perceptions of endometrial cancer risk.Gynecologic oncology · 2026Article
- Machine learning identifies a DNA repair-related risk model for bladder cancer and functionally characterizes ZWINT as a potential oncogenic factor.Translational andrology and urology · 2026Article
- Review
- Homologous Recombination Deficiency and Survival in Ovarian High-Grade Serous Carcinoma by Self-Reported Race.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- BRCA testing utilization among commercially insured women with breast or ovarian cancer.Breast cancer research and treatment · 2025Article
- Patient characteristics, treatment patterns, and clinical outcomes in HER2-negative early breast cancer by germline BRCA status.Future oncology (London, England) · 2025Observational
- Prevalence of clinician-ordered genetic testing in rural and urban United States counties: An analysis of the 2022 Health Information National Trends Survey.Preventive medicine reports · 2025Article
- Real-world post-2020 first-line maintenance treatment patterns in patients with advanced ovarian cancer in the US.Future oncology (London, England) · 2025Article
- Improving genetics equity: identifying women eligible for genetic care services using mammography clinics in underserved areas as screening hubs.The oncologist · 2025Article
- Germline Genetic Testing in Patients With Solid Malignant Tumors.JAMA network open · 2025Article
- Call to action for genetic counseling research in hereditary cancer: Considerations from the evidence-based guidelines development process.Journal of genetic counseling · 2025Article
- Genomic Screening at a Single Health System.JAMA network open · 2025Article
- Incorporating Structured and Unstructured Data Sources to Identify and Characterize Hereditary Cancer Testing Among Veterans With Metastatic Castration-Resistant Prostate Cancer.JCO clinical cancer informatics · 2025Article
- Real-World Treatment Patterns and Cost of Care in US Ovarian Cancer Patients Undergoing BRCA Testing.Journal of health economics and outcomes research · 2025Article
- Psychometric Properties of a Culturally Adapted Spanish Version of the Attitudes toward Genomics and Precision Medicine Instrument.Public health genomics · 2025Article
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4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundGermline genetic testing (GT) for BRCA1/2 is instrumental in identifying patients with breast and ovarian cancers who are eligible for PARP inhibitors (PARPi). Little is known about recent trends and determinants of GT since PARPi were approved for these patients. PATIENTS AND
methodsWe performed a retrospective cohort study of patients in a nationwide electronic health record (EHR)-derived oncology-specific database with the following GT eligibility criteria: breast cancer diagnosed at age ≤45 years, triple-negative breast cancer diagnosed at age ≤60 years, male breast cancer, or ovarian cancer. GT within 1 year of diagnosis was assessed and stratified by tumor type. Multivariable log-binomial regressions estimated adjusted relative risks (RRs) of GT by patient and tumor characteristics.
resultsAmong 2,982 eligible patients with breast cancer, 56.4% underwent GT between January 2011 and March 2020, with a significant increase in GT over time (RR, 1.08; 95% CI, 1.05-1.11, for each year), independent of when PARPi were approved for BRCA1/2-mutated metastatic breast cancer in January 2018. In multivariable analyses, older age (RR, 0.93; 95% CI, 0.90-0.96, for every 5 years) and Medicare coverage (RR, 0.69; 95% CI, 0.49-0.96 vs commercial insurance) were associated with less GT. Among 5,563 eligible patients with ovarian cancer, 35.4% underwent GT between January 2011 and March 2020, with a significant increase in GT over time (RR, 1.11; 95% CI, 1.07-1.14, for each year) that accelerated after approval of PARPi for BRCA1/2-mutated, chemotherapy-refractory ovarian cancer in December 2014 (RR, 1.42; 95% CI, 1.19-1.70). Older age (RR, 0.95; 95% CI, 0.93-0.97, for every 5 years) and Black or African American race (RR, 0.80; 95% CI, 0.65-0.98 vs White race) were associated with less GT.
conclusionsGT remains underutilized nationwide among patients with breast and ovarian cancers. Although GT has increased over time, significant disparities by age, race, and insurance status persist. Additional work is needed to design, implement, and evaluate strategies to ensure that all eligible patients receive GT.
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