{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T23:46:35Z","timestamp":1762386395945,"version":"build-2065373602"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U01CA244323"],"award-info":[{"award-number":["U01CA244323"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Genetic Counseling"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Approximately 20% of individuals diagnosed with ovarian cancer (OC) have an inherited pathogenic or likely pathogenic variant (P\/LP) in a cancer risk gene. Though genetic testing for hereditary cancer risk is currently recommended at OC diagnosis, individuals who have not received risk information and their at\u2010risk relatives (ARR) can benefit from genetic testing at any point. In a single\u2010arm implementation study, the Genetic Risk Assessment in Ovarian CancEr (GRACE) study offered traceback genetic testing using a panel of cancer risk genes to (1) living survivors with a prior OC diagnosis who had not received genetic testing at diagnosis and (2) first\u2010degree relatives of deceased eligible probands with a prior OC diagnosis who had not received genetic testing. For survivors and first\u2010degree relatives with a positive result (i.e., P\/LP detected), we offered cascade testing to ARR, including providing support resources to facilitate communication with their relatives and offering to directly contact relatives. Traceback testing occurred on average 10\u201312\u2009years from the incident OC diagnosis, resulting in 20 positive findings with 93 ARR eligible for cascade testing. Overall, cascade testing uptake was 38%, with similar rates among relatives of living (40%) and deceased (33%) probands. Cascade testing identified 11 individuals with OC\u2010risk variants and 3 incidental findings in genes not associated with OC risk. Women were more likely to complete cascade testing than men (45% vs. 30%, respectively). Initially, only two probands consented to direct contact with ARR by the study genetic counselor; 6 additional probands requested direct contact with relatives over subsequent interactions. These findings represent some of the first U.S. data available on cascade testing outcomes of traceback programs and suggest feasibility and effectiveness in U.S. health system settings.<\/jats:p>","DOI":"10.1002\/jgc4.70133","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T23:43:19Z","timestamp":1762386199000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cascade testing in an ovarian cancer traceback genetic testing program: The\n                    <scp>GRACE<\/scp>\n                    study experience"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7240-2151","authenticated-orcid":false,"given":"Jamilyn M.","family":"Zepp","sequence":"first","affiliation":[{"name":"Department of Translational and Applied Genomics Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6691-3740","authenticated-orcid":false,"given":"Heather S.","family":"Feigelson","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Colorado Institute for Health Research  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolanda K.","family":"Prado","sequence":"additional","affiliation":[{"name":"Department of Translational and Applied Genomics Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana A.","family":"Reyes","sequence":"additional","affiliation":[{"name":"Department of Translational and Applied Genomics Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7926-4612","authenticated-orcid":false,"given":"Alan F.","family":"Rope","sequence":"additional","affiliation":[{"name":"Department of Translational and Applied Genomics Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest  Portland Oregon USA"},{"name":"Genome Medical  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer K.","family":"Sawyer","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Colorado Institute for Health Research  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-0070","authenticated-orcid":false,"given":"Sheila","family":"Weinmann","sequence":"additional","affiliation":[{"name":"Department of Translational and Applied Genomics Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9364-2704","authenticated-orcid":false,"given":"Larissa L.","family":"White","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Colorado Institute for Health Research  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1117-1097","authenticated-orcid":false,"given":"Jessica Ezzell","family":"Hunter","sequence":"additional","affiliation":[{"name":"Department of Translational and Applied Genomics Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest  Portland Oregon USA"},{"name":"Genomics, Ethics, and Translational Research Program RTI International  Research Triangle Park North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3459-7787","authenticated-orcid":false,"given":"Nora B.","family":"Henrikson","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.pecinn.2023.100138","article-title":"Do people with hereditary cancer syndromes inform their at\u2010risk relatives? A systematic review and meta\u2010analysis","volume":"2","author":"Ahsan M. 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M.","year":"2020","journal-title":"Genetics in Medicine"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1159\/000541532","article-title":"\u201cI didn't have to worry about it\u201d: Patient and family experiences with health system involvement in notifying relatives of genetic test results","volume":"27","author":"Blasi P. R.","year":"2024","journal-title":"Public Health Genomics"},{"key":"e_1_2_12_9_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41525-019-0096-5","article-title":"Impact of free cancer predisposition cascade genetic testing on uptake in Singapore","volume":"4","author":"Courtney E.","year":"2019","journal-title":"NPJ Genomic Medicine"},{"issue":"10","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.6004\/jnccn.2023.0051","article-title":"NCCN Guidelines(R) Insights: Genetic\/familial high\u2010risk assessment: Breast, ovarian, and pancreatic, version 2.2024","volume":"21","author":"Daly M. 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L.","year":"2024","journal-title":"Cancers (Basel)"}],"container-title":["Journal of Genetic Counseling"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgc4.70133","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T23:43:23Z","timestamp":1762386203000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgc4.70133"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/jgc4.70133"],"URL":"https:\/\/doi.org\/10.1002\/jgc4.70133","archive":["Portico"],"relation":{},"ISSN":["1059-7700","1573-3599"],"issn-type":[{"value":"1059-7700","type":"print"},{"value":"1573-3599","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]},"assertion":[{"value":"2025-05-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70133"}}