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The purpose of this study was to measure the long\u2010term utilization of targeted cancer prevention and quality of life among at\u2010risk relatives offered clinician\u2010facilitated cascade genetic testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a pilot study, at\u2010risk relatives of patients with a hereditary cancer syndrome were contacted directly by the clinical team and offered telephone genetic counseling and genetic testing via an at\u2010home, mailed saliva kit. Two\u2010year follow\u2010up results evaluating the use of targeted cancer prevention strategies and the quality of life for enrolled relatives were reported. Quality\u2010of\u2010life was measured with validated surveys, and scores were compared to the time of initial contact by the Wilcoxon signed\u2010rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010five at\u2010risk relatives were enrolled in the initial pilot study, and 72 (76%) participated in the 2\u2010year follow\u2010up; 57 of these (79%) had completed genetic testing. Twenty\u2010five of those 57 relatives (44%) were found to harbor an inherited pathogenic variant. Guideline\u2010based cancer surveillance was recommended to 18 relatives; 13 (72%) completed at least one recommended screening, and six (33%) completed all recommended screenings. Risk\u2010reducing surgery was recommended to 10 relatives; four (40%) completed a total of eight procedures. Quality\u2010of\u2010life surveys demonstrated low levels of anxiety, depression, distress, and uncertainty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The 2\u2010year follow\u2010up of the original pilot study revealed that clinician\u2010facilitated cascade testing resulted in genetically targeted cancer screening and prevention with preserved quality of life. These results, to be confirmed by larger randomized controlled trials, suggest that medical systems should consider supporting clinician\u2010facilitated cascade testing programs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34482","type":"journal-article","created":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T02:41:16Z","timestamp":1666924876000},"page":"4241-4250","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["What happens in the long term: Uptake of cancer surveillance and prevention strategies among at\u2010risk relatives with pathogenic variants detected via cascade testing"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6705-1211","authenticated-orcid":false,"given":"Melissa K.","family":"Frey","sequence":"first","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad 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