Evidence map›Paper›PMID 41085774›Full record

ArticleFamilial cancer2025

Barriers and facilitators for medical oncologists in the further implementation of mainstream genetic testing in breast cancer care in the Netherlands.

Chiem L de Jong, Gina Schijven, Ellen G Engelhardt, Agnes Jager, Margreet G E M Ausems

Erratum issuedAbstract read
In one paragraph

Article in Familial cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Chiem L de JongDivision Laboratories, Pharmacy and Biomedical Genetics, Department of Genetics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.ORCID 0009-0008-1630-905X
Gina SchijvenDivision Laboratories, Pharmacy and Biomedical Genetics, Department of Genetics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Ellen G EngelhardtDivision of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.ORCID 0000-0003-0016-4972
Agnes JagerDepartment of Medical Oncology, Erasmus University MC Cancer Institute, Dr. Molewaterplein 40, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.ORCID 0000-0002-7713-1450
Margreet G E M AusemsDivision Laboratories, Pharmacy and Biomedical Genetics, Department of Genetics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. m.g.e.m.ausems@umcutrecht.nl.ORCID 0000-0003-0305-3477

Funding

AstraZeneca aznl202300195
6 · The paper itself

Abstract

Only 67% of eligible patients with breast cancer currently undergo genetic testing. Mainstream genetic testing (i.e. healthcare professionals (HCPs) from outside the genetics field providing genetic counselling), also referred to asmainstreaming, leads to increased uptake of genetic testing. Unlike surgical oncologists, medical oncologists have not yet widely adopted mainstreaming. This study aims to identify barriers and facilitators for HCPs, in particular medical oncologists, in advancing the implementation of mainstreaming. Structured interviews were conducted with HCPs (predominantly medical oncologists) using the Constructive Technology Assessment (CTA) framework. Participants were recruited from all regions of the Netherlands, ensuring representation from academic medical centres, teaching hospitals and general hospitals. The interview data was analysed using thematic analysis. In this qualitative study, 12 medical oncologists, three nurse practitioners, three clinical geneticists, two clinical laboratory geneticists and one representative of a health insurer were interviewed. Lack of time and limited knowledge were the most commonly mentioned barriers, whilst effective cross-departmental collaboration and education were the most important facilitators. For medical oncologists specifically, financial compensation for the increased workload and the increasing importance of genetic testing for guiding therapy choices were found to be encouraging factors. This study identified several barriers and facilitators to mainstreaming being implemented by medical oncologists. Education to strengthen oncologists' skills in discussing germline genetic testing may address knowledge gaps and time barriers. Alongside cross-departmental collaboration, these strategies could streamline genetic testing pathways. Further research should evaluate their implementation and effects on patient experience and equitable access.

Indexed as

Breast NeoplasmsGenetic TestingMedical OncologyOncologistsAttitude of Health PersonnelClinical CompetenceFemaleGenetic CounselingHumansInterviews as TopicMaleNetherlandsPractice Patterns, Physicians'Qualitative ResearchReferral and ConsultationTime FactorsBarriers and facilitatorsBreast cancerDisparities.Genetic testingMainstream genetic testingMedical oncologists

Identifiers

PMID41085774
PMCPMC12521265

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Registered trials

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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.