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However, treatment-directed testing does not necessarily lead to genetic counseling, germline genetic testing, cascade testing, or familial risk management. Prostate cancer therefore presents a unique implementation challenge, particularly in tumor-first testing pathways.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a narrative review of international literature on barriers to germline genetic testing and genetic counseling in prostate cancer, an environmental scan of publicly available Japanese sources, and targeted international comparisons of genetics specialist workforce and academic visibility. The findings were integrated into a logic model for hereditary cancer care implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>International evidence identified multilevel barriers, including variation in genetic knowledge and training opportunities among urologists, difficulty identifying eligible patients, communication and workflow constraints, limited access to genetics services, financial barriers, low patient awareness, and psychosocial and gender-related factors. The Japanese environmental scan indicated incomplete linkage from tumor genomic testing to genetic counseling, underrepresentation of urologists among genetics specialists, low academic visibility, and limited emphasis on familial risk management in patient materials, guidelines, and education. The logic model highlighted family history assessment, recognition of tumor-first genomic findings, embedded referral pathways, and patient-centered information support as key intervention points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The implementation gap reflects a structural disconnect between prostate cancer genomics and hereditary cancer care. Pathway redesign may help link tumor genomic testing with germline genetic testing and familial risk management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10147-026-03209-6","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:36:58Z","timestamp":1791373018000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bridging the implementation gap in hereditary cancer care for prostate cancer: a narrative review and Japanese environmental scan"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2587-7961","authenticated-orcid":false,"given":"Eri","family":"Habano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6239-6050","authenticated-orcid":false,"given":"Yusuke","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8685-2099","authenticated-orcid":false,"given":"Miho","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4670-3679","authenticated-orcid":false,"given":"Kousuke","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4610-0755","authenticated-orcid":false,"given":"Nana","family":"Akiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyangri","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7479-0035","authenticated-orcid":false,"given":"Eri","family":"Shijiki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3686-7134","authenticated-orcid":false,"given":"Saeko","family":"Nagai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9989-8258","authenticated-orcid":false,"given":"Akiko","family":"Kunita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9205-5452","authenticated-orcid":false,"given":"Arisa","family":"Ueki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3658-4442","authenticated-orcid":false,"given":"Hidenori","family":"Kage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2468-9573","authenticated-orcid":false,"given":"Katsutoshi","family":"Oda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"3209_CR1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.7334","volume":"13","author":"MEV Caram","year":"2024","unstructured":"Caram MEV, Kumbier K, Tsao PA et al (2024) Survival by first-line therapy and prognostic group among men with metastatic castration-resistant prostate cancer. 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K.W. is affiliated with an endowed chair funded by Konica Minolta, Inc. and GenMine Labs Corp.; received research funding from Konica Minolta, Inc. and GenMine Labs Corp.; and received lecture fees from GenMine Labs Corp. A.U. received research funding from Pfizer Japan Inc. and lecture fees from Myriad Genetics G.K. A.K. is affiliated with an endowed chair funded by Konica Minolta, Inc. and GenMine Labs Corp. H.K. is affiliated with an endowed chair funded by Konica Minolta, Inc.; received research funding from Konica Minolta, Inc.; and received lecture fees from GenMine Labs Corp. and AstraZeneca. K.O. received research funding from Konica Minolta, Inc., GenMine Labs Corp., and AstraZeneca, and lecture fees from AstraZeneca, GenMine Labs Corp., Chugai Pharmaceutical Co., Ltd., and MSD Co., Ltd. The other authors declare that they have no conflict of interest.","order":1,"name":"Ethics","label":"Conflict of interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}