ArticleBreast cancer research : BCR2025
The impact of a mainstream genetic testing pathway and socioeconomic factors on the uptake of germline genetic testing in breast cancer patients: results of the nationwide GENE-SMART study.
Article in Breast cancer research : BCR, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Genetic Testing Uptake Among Patients With Newly Diagnosed Breast Cancer.JAMA network open · 2026Article
- The evolution of hereditary cancer genetic counselling: mainstreaming, service redesign and patient experience in Lynch syndrome.Familial cancer · 2026Review
- EBCC-15 manifesto: Removing age-related barriers to improve equity in breast cancer care.Breast (Edinburgh, Scotland) · 2026Review
- Mainstreaming genetic testing in community oncology settings.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Clinical predictors ofFrontiers in oncology · 2026Article
- Hereditary cancer syndromes with gynecological cancer risk: focus on prevention strategies.Frontiers in oncology · 2026Review
- Barriers and facilitators for medical oncologists in the further implementation of mainstream genetic testing in breast cancer care in the Netherlands.Familial cancer · 2025Article
- Current Status and Challenges ofCancer diagnosis & prognosisArticle
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5 authors.
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Abstract
backgroundGenetic testing in breast cancer patients is important for the patient's local and systemic treatment choices and follow-up, as well as for their family members. Not all eligible patients currently undergo genetic testing and disparities persist in genetic testing uptake. It is unknown on the large scale whether pre-test counselling by non-genetic healthcare professionals (HCPs)-mainstream genetic testing (MGT) - improves overall genetic testing uptake and reduces disparities. We examined the impact of MGT on germline genetic testing uptake in general and in subgroups of socioeconomic status (SES) in particular.
methodsIn this retrospective nationwide cohort study, we selected all breast cancer patients from the Netherlands Cancer Registry who were eligible for genetic testing according to patient and tumour characteristics under the Dutch guidelines and who were diagnosed between 1-Jan-2017 and 31-Dec-2022. The primary outcome was genetic testing uptake. The influence of MGT and SES on overall uptake and uptake across different SES levels was evaluated using chi-squared tests and multivariable logistic regression analyses.
resultsA total of 12,071 breast cancer patients were included. Overall genetic testing uptake was 67%: 78% for MGT versus 63% in referral to a genetics department (RGD) (p < 0.001) with significantly higher odds of receiving genetic testing for MGT versus RGD (OR 2.48, 95% CI 2.14-2.87). Patients with low SES showed significantly lower odds of receiving genetic testing compared to those with a high SES (OR 0.71, 95% CI 0.61-0.83). In MGT, no significant difference was found between low and high SES in the likelihood of receiving genetic testing (OR 0.75, 95% CI 0.50-1.13).
conclusionsMGT significantly increases genetic testing uptake among all eligible patients and across all SES subgroups, strongly encouraging further implementation of MGT. Educating HCPs about current disparities in genetic testing is essential to improve health equity in breast cancer care.
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