More genetic testing, earlier screening options

Adult survivors of childhood cancers are at higher risk for another cancer—such as breast, colorectal, sarcomas and thyroid cancer—that is not a relapse of their original illness. Previous cancer therapies are largely responsible. However, up to 13% of survivors also have a hereditary predisposition that elevates their risk of subsequent cancer.

A recent clinical trial has found that genetic services via remote centralized telehealth and in collaboration with primary care increased the uptake of genetic counseling and testing in this population. Results are published in The Lancet Regional Health–Americas.

“Identifying survivors with cancer-predisposing genetic variants allows personalized survivorship care with early screenings and preventive measures,” said lead author Tara Henderson, MD, MPH, childhood cancer survivorship expert and Chair of Pediatrics at Ann & Robert H. Lurie Children’s Hospital of Chicago, as well as Professor of Pediatrics at Northwestern University Feinberg School of Medicine.

“Our study is the first national randomized trial to show that remote telehealth services, working with primary care providers, improve access to genetic counseling and testing for adult survivors of childhood cancers. Genetic services also drive earlier detection of subsequent cancer, which reduces morbidity and mortality.”

The study included 391 participants with a mean age of 44 years. All participants were provided with information on the benefits of genetic testing. Dr. Henderson and colleagues found that at six months, 43% of participants in the remote telehealth services group had received genetic services, compared to 15% in the usual care group.

“Notably, 10% of participants who completed genetic testing in the telehealth group had actionable results, which underscores the significant impact of this intervention for the survivors and their families,” said Dr. Henderson. “Better access to genetic services is critical for improving outcomes in childhood cancer survivors.

“We show that integrating remote genetic services in primary care works well, although more survivors still need to pursue genetic testing. Enhancing motivation for testing may require personalized decision aids, further education about its benefits, and financial support mechanisms to reduce concerns about testing costs.”