Personalized support increases genetic testing for hereditary cancers among immediate family members

by University of Texas MD Anderson Cancer Center

edited by Sadie Harley, reviewed by Andrew Zinin

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First-degree relatives—parents, siblings and children—of cancer patients who received personalized support and navigation services throughout the genetic testing process were significantly more likely to receive genetic testing themselves. Nearly half of those relatives carried a BRCA1 or BRCA2 mutation associated with a higher risk of cancer, according to a new study by researchers at The University of Texas MD Anderson Cancer Center.

The findings, published in the Journal of Clinical Oncology, show that with personalized support, genetic testing uptake for BRCA increased from 51% to 73% among at-risk family members in six months. The results highlight a promising strategy to improve the use of cascade genetic testing, a process in which family members of someone known to carry a cancer-related genetic mutation are offered testing to determine whether they also inherited the variant.

"This study demonstrates that simply informing relatives of their inherited cancer risk is not enough," said Roni Wilke, M.D., assistant professor of Gynecologic Oncology & Reproductive Medicine.

"When we provided navigation to help people through the testing process, we noticed a meaningful difference in utilization and how soon people completed their testing. This creates new opportunities to enhance screening, prevention and early intervention for several hereditary cancers."

Navigation boosts testing completion

Researchers enrolled 286 first-degree relatives of 151 individuals recently identified as carrying BRCA1 or BRCA2 mutations, which are linked to elevated risks of breast, ovarian, prostate and other cancers. Trial participants were assigned to either a facilitated testing program that included navigation support and streamlined access to genetic testing services or standard of care, which included receiving a family notification letter.

In addition to the 43% increase in genetic testing in six months, 90% of relatives in the facilitated testing group completed testing by 18 months. Of the 206 relatives who completed testing, 46% were found to carry a BRCA1 or BRCA2 mutation associated with a higher risk of cancer. Among this group, 86% carried the same familial BRCA mutation identified in their family member.

Removing barriers to inherited-risk testing

Genetic testing can help identify inherited cancer risk years before symptoms appear, providing opportunities for early intervention that can prevent or treat cancer. However, many family members never pursue it. Barriers can include confusion about the process, concerns about cost and difficulty accessing testing.

The study's findings suggest that programs that identify and inform relatives of their inherited cancer risk and actively assist families with cascade genetic testing have the potential to improve health outcomes across entire families.

Publication details

Roni Nitecki Wilke et al, Facilitated Cascade Genetic Testing for Relatives of Individuals With BRCA1/2 Pathogenic Variants: A Randomized Controlled Trial, Journal of Clinical Oncology (2026). DOI: 10.1200/jco-26-00735

Journal information: Journal of Clinical Oncology

Key medical concepts

BRCA1 DNA repair associatedBRCA2 DNA repair associated

Clinical categories

OncologyClinical genetics Provided by University of Texas MD Anderson Cancer Center Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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