Disparities in Germline Genetic Testing Rates Exist, but Mechanisms Remain Unclear

Barb Kunz, MS, LCGC, senior genetic counselor at the US Oncology Network, discussed the importance of germline genetic testing in patients with triple-negative breast cancer and other cancer types.

In a study presented at the 2023 American Society of Clinical Oncology Annual Meeting, Kunz and colleagues found that social determinants of health, particularly related to race and the type of insurance coverage patients had, impacted genetic testing rates in the community oncology setting.

Transcript

What are the implications of these findings for patients with TNBC and other cancer types where germline testing is recommended?

I think the biggest implication is trying to understand why these differences exist, and how can we address them? And where along the whole genetic testing workflow these people weren't getting what they needed. Were they not identified in the first place for genetic testing? Were they not referred, were they referred and didn't have an appointment? If they had an appointment, why did they choose not to do testing?

And it's not that everyone should do testing—people have options and real reasons why they don't do testing. But we need to understand why there's that discrepancy and address it. And it will apply to other cancers. Can we do systemic things like change workflows to make sure that people don't overlook these indications for genetic testing? Because the indications for genetic testing are just going to keep increasing, and we need our providers really understand that, and our patients [need to] understand the value of genetic testing.