{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T06:09:16Z","timestamp":1788761356410,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Genetic Counseling"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Barriers to germline genetic testing (GT) for cancer include cost, limited genetic literacy, and socio\u2010cultural factors. This study comprehensively evaluated awareness, attitudes, and expectations (AAE) regarding hereditary cancer and GT among Indian cancer patients and caregivers across diverse adult and pediatric cancers. A prospective cross\u2010sectional survey was conducted at the Cancer Genetics Clinic, Tata Memorial Centre, Mumbai between 2023 and 2025. Five hundred participants (227 patients, 273 caregivers) were recruited equally across breast, gynecological, colorectal, central nervous system, and pediatric cancers. A validated 13\u2010item questionnaire administered in four languages assessed hereditary cancer awareness, knowledge of GT implications, disclosure attitudes, and expectations regarding cost and turnaround time (TAT). Binary logistic regression identified predictors of awareness and acceptability. Only 45.8% of participants were aware that cancer can be hereditary. Biology education, family history of cancer, and breast\/gynecological cancer diagnosis were significant positive predictors of awareness. Among those aware of hereditary cancer, 36.6% misattributed familial clustering to shared habits rather than germline pathogenic variants. Only 29.9% identified GT as the means to confirm hereditary cancer. Regarding GT implications, 41.1% recognized its impact on treatment, screening, and family risk simultaneously. Over half (54.8%) found the current GT cost of \u20b915,000\u201320,000 unacceptable, with a mean willingness\u2010to\u2010pay threshold of \u20b99903 (~USD 116). Conversely, 59.9% accepted a 3\u20136\u2010week TAT. Non\u2010disclosure of cancer diagnosis beyond immediate family was associated with non\u2010English language preference suggesting socio\u2010cultural barriers. Despite low awareness, 91.6% of participants consented to genetic testing following counseling. This first pan\u2010cancer AAE study from an LMIC reveals critical gaps in genetic literacy and a clear affordability threshold for GT. Subsidizing testing to approximately \u20b910,000, expanding regional\u2010language digital health education, and strengthening pre\u2010test counseling are essential to mainstream genetic services in India.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    This study is registered at Clinical Trials Registry\u2010 India CTRI\/2022\/05\/042558 on 13.05.2022\n                  <\/jats:p>","DOI":"10.1002\/jgc4.70287","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T05:59:12Z","timestamp":1788760752000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Awareness, Attitudes, and Expectations of Indian Cancer Patients and Their Caregivers on Hereditary Cancers and Genetic Testing at a Tertiary Cancer Centre in India"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4887-7130","authenticated-orcid":false,"given":"Rima Sanjay","family":"Pathak","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Tata Memorial Centre  Mumbai India"},{"name":"Homi Bhabha National Institute  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akanksha","family":"Angre","sequence":"additional","affiliation":[{"name":"Cancer Genetics Clinic Tata Memorial Centre  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Talker","sequence":"additional","affiliation":[{"name":"Cancer Genetics Clinic Tata Memorial Centre  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6405-8282","authenticated-orcid":false,"given":"Rajiv","family":"Sarin","sequence":"additional","affiliation":[{"name":"Homi Bhabha National Institute  Mumbai India"},{"name":"Department of Radiation Oncology, In\u2010Charge of Cancer Genetics Unit Tata Memorial Centre  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.glmedi.2023.100009","article-title":"Inequality and Disparities in Health Insurance Enrolment in India","volume":"1","author":"Aashima","year":"2023","journal-title":"Journal of Medicine, Surgery, and Public Health"},{"key":"e_1_2_14_3_1","doi-asserted-by":"crossref","DOI":"10.2196\/67650","article-title":"The Role of Online Support, Caregiving, and Gender in Preventative Cancer Genetic Testing Participation: Cross\u2010Sectional Study From a National Study","volume":"11","author":"Agrawal L.","year":"2025","journal-title":"JMIR Cancer"},{"key":"e_1_2_14_4_1","doi-asserted-by":"crossref","first-page":"282","DOI":"10.4103\/jfmpc.jfmpc_193_22","article-title":"Myths, Beliefs, and Attitude Toward Cancer Among the Family Caregivers of Cancer Patients: A Community\u2010Based, Mixed\u2010Method Study in Rural Tamil Nadu","volume":"12","author":"Ajith K.","year":"2023","journal-title":"Journal of Family Medicine and Primary Care"},{"key":"e_1_2_14_5_1","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/01.gim.0000182895.28432.c7","article-title":"Deficiency of Knowledge of Genetics and Genetic Tests Among General Practitioners, Gynecologists, and Pediatricians: A Global Problem","volume":"7","author":"Baars M. J. H.","year":"2005","journal-title":"Genetics in Medicine"},{"key":"e_1_2_14_6_1","doi-asserted-by":"crossref","DOI":"10.3389\/fgene.2024.1335768","article-title":"Stigma Associated With Genetic Testing for Rare Diseases\u2014Causes and Recommendations","volume":"15","author":"Baynam G.","year":"2024","journal-title":"Frontiers in Genetics"},{"key":"e_1_2_14_7_1","doi-asserted-by":"crossref","first-page":"viii559","DOI":"10.1093\/annonc\/mdy296.006","article-title":"Cancer Stigma Related to Beliefs of Patients and Care Providers","volume":"29","author":"Bhattacharyya G. S.","year":"2018","journal-title":"Annals of Oncology"},{"key":"e_1_2_14_8_1","doi-asserted-by":"crossref","DOI":"10.3389\/fgene.2020.512582","article-title":"Knowledge, Awareness, and Perception of Genetic Testing for Hereditary Disorders Among Malaysians in Klang Valley","volume":"11","author":"Chin J. 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N.","year":"2021","journal-title":"JCO Precision Oncology"},{"key":"e_1_2_14_18_1","doi-asserted-by":"crossref","DOI":"10.1002\/jgc4.70105","article-title":"Awareness and Knowledge of Familial Breast and Ovarian Cancer Among German General Practice Patients","volume":"34","author":"Guertler D.","year":"2025","journal-title":"Journal of Genetic Counseling"},{"key":"e_1_2_14_19_1","doi-asserted-by":"crossref","DOI":"10.1136\/fmch-2025-003395","article-title":"Acceptance and Attitudes Towards Genetic Cancer Testing Among German General Practice Patients: A Cross\u2010Sectional Survey","volume":"13","author":"Guertler D.","year":"2025","journal-title":"Family Medicine and Community Health"},{"key":"e_1_2_14_20_1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1007\/s13187-020-01823-0","article-title":"Knowledge, Attitudes, Willingness to Pay, and Patient Preferences About Genetic Testing and Subsequent Risk Management for Cancer Prevention","volume":"37","author":"Guo F.","year":"2020","journal-title":"Journal of Cancer Education"},{"issue":"1","key":"e_1_2_14_21_1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1186\/s12889-017-4375-8","article-title":"Awareness, Knowledge, Perceptions, and Attitudes Towards Genetic Testing for Cancer Risk Among Ethnic Minority Groups: A Systematic Review","volume":"17","author":"Hann K. 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L.","year":"2025","journal-title":"International Journal of Medical Sciences"},{"key":"e_1_2_14_27_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.gim.2025.101665","article-title":"Barriers and Facilitators to Implementing Clinical Genome\u2010Wide Sequencing: A Scoping Review of the Global Landscape","volume":"28","author":"Lee W.","year":"2026","journal-title":"Genetics in Medicine"},{"key":"e_1_2_14_28_1","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.amepre.2014.01.002","article-title":"Awareness of Cancer Susceptibility Genetic Testing: The 2000, 2005, and 2010 National Health Interview Surveys","volume":"46","author":"Mai P. L.","year":"2014","journal-title":"American Journal of Preventive Medicine"},{"key":"e_1_2_14_29_1","first-page":"1588","article-title":"Feasibility of Cancer Genetic Counselling and Screening in Cameroon: Perceived Benefits and Barriers","volume":"17","author":"Mapoko B. S. 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M.","year":"2024","journal-title":"Egyptian Nursing Journal"},{"key":"e_1_2_14_32_1","unstructured":"National Comprehensive Cancer Network (NCCN).2026.\u201cGenetic\/Familial High\u2010Risk Assessment: Breast Ovarian Pancreatic and Prostate\u2014Guidelines Detail.\u201d"},{"key":"e_1_2_14_33_1","first-page":"1","article-title":"Awareness and Utilization of Genetic Testing for Hereditary Cancers in Cancer Survivors: A Cross\u2010Sectional 2021 HINTS\u2010SEER Study","volume":"2025","author":"Ramalingam K.","year":"2025","journal-title":"Journal of Cancer Survivorship"},{"key":"e_1_2_14_34_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.gore.2024.101427","article-title":"Self\u2010Reported Awareness of Genetic Testing, the Impact of Family History, and Access to Clinical Trials for People Diagnosed With Ovarian Cancer in Australia","volume":"54","author":"Roczo D.","year":"2024","journal-title":"Gynecologic Oncology Reports"},{"key":"e_1_2_14_35_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4103\/oji.oji_51_19","article-title":"Cancer and Stigma: Present Situation and Challenges in India","volume":"3","author":"Sahoo S.","year":"2019","journal-title":"Oncology Journal of India"},{"key":"e_1_2_14_36_1","doi-asserted-by":"crossref","DOI":"10.3389\/fgene.2022.865384","article-title":"Barriers and Facilitators for Population Genetic Screening in Healthy Populations: A Systematic Review","volume":"13","author":"Shen E. 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