{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T07:46:03Z","timestamp":1785829563345,"version":"3.56.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004622","name":"KWF Kankerbestrijding","doi-asserted-by":"publisher","award":["12732"],"award-info":[{"award-number":["12732"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]},{"name":"KWF Kankerbestrijding, The Netherlands","award":["12732"],"award-info":[{"award-number":["12732"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Familial Cancer"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Genetic testing in ovarian carcinoma (OC) patients is very important for patients and their relatives. The Tumor-First workflow uses a tumor DNA test to stratify germline testing for hereditary cancer predisposition as well as treatment options with PARP inhibitors. This workflow is adopted and successfully implemented nationwide. Here, we evaluated recent tumor DNA testing rates in the Netherlands to identify untested OC patient groups and optimize tumor DNA testing rates. OC patients diagnosed in 2023 or 2024 were selected from the Netherlands Cancer Registry. We analyzed patient characteristics associated with the likelihood of tumor DNA testing using multivariable logistic regression. Tumor-First testing was performed for 1765 out of the 2221 (79%) OC patients. Patients diagnosed with advanced stage OC were more likely to receive tumor DNA testing (OR\u2009=\u20092.5,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) than those with low-stage disease. Compared with patients who underwent surgery as primary treatment, those who received chemotherapy or no primary treatment were less likely to be tested (OR\u2009=\u20090.21 and OR\u2009=\u20090.07, respectively,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Patients who died within 100 days were less likely to receive testing (OR\u2009=\u20090.57,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.003). Patients without resection after diagnosis on biopsy\/cytology had the lowest Tumor-First testing rates (58% vs. 87\u201395%, \u03c72\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Tumor-First testing rates are high. However, OC patients that do not undergo a resection are less likely to undergo testing. With these data strategies to identify hereditary cancer predisposition in patients and their relatives can be further improved.\n                  <\/jats:p>","DOI":"10.1007\/s10689-026-00592-x","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:56:32Z","timestamp":1785826592000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Opportunities to improve detection of genetic predisposition for ovarian cancer applying the Tumor-First workflow"],"prefix":"10.1007","volume":"25","author":[{"given":"Vera M.","family":"Witjes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne A.","family":"de Hullu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"van Remortele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Vreede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Simons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoline","family":"Hoogerbrugge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolijn J. L.","family":"Ligtenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"issue":"4","key":"592_CR1","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s11523-023-00970-w","volume":"18","author":"DM O\u2019Malley","year":"2023","unstructured":"O\u2019Malley DM, Krivak TC, Kabil N, Munley J, Moore KN (2023) PARP inhibitors in ovarian cancer: a review. Target Oncol 18(4):471\u2013503. https:\/\/doi.org\/10.1007\/s11523-023-00970-w","journal-title":"Target Oncol"},{"issue":"2","key":"592_CR2","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1002\/humu.23137","volume":"38","author":"RD Weren","year":"2017","unstructured":"Weren RD, Mensenkamp AR, Simons M et al (2017) Novel BRCA1 and BRCA2 tumor test as basis for treatment decisions and referral for genetic counselling of patients with ovarian carcinomas. Hum Mutat 38(2):226\u2013235. https:\/\/doi.org\/10.1002\/humu.23137","journal-title":"Hum Mutat"},{"issue":"2","key":"592_CR3","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1093\/jnci\/djz080","volume":"112","author":"JR Vos","year":"2020","unstructured":"Vos JR, Fakkert IE, de Hullu JA et al (2020) Universal tumor DNA BRCA1\/2 testing of ovarian cancer: prescreening PARPi treatment and genetic predisposition. J Natl Cancer Inst 112(2):161\u2013169. https:\/\/doi.org\/10.1093\/jnci\/djz080","journal-title":"J Natl Cancer Inst"},{"issue":"4","key":"592_CR4","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1007\/s10689-024-00398-9","volume":"23","author":"VM Witjes","year":"2024","unstructured":"Witjes VM, Hermkens DMA, Swillens JEM et al (2024) Optimizing the detection of hereditary predisposition in women with epithelial ovarian cancer: nationwide implementation of the tumor-first workflow. Fam Cancer 23(4):429\u2013436. https:\/\/doi.org\/10.1007\/s10689-024-00398-9","journal-title":"Fam Cancer"},{"key":"592_CR5","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.ygyno.2023.04.029","volume":"174","author":"VM Witjes","year":"2023","unstructured":"Witjes VM, Ligtenberg MJL, Vos JR et al (2023) The most efficient and effective BRCA1\/2 testing strategy in epithelial ovarian cancer: tumor-first or germline-first? Gynecol Oncol 174:121\u2013128. https:\/\/doi.org\/10.1016\/j.ygyno.2023.04.029","journal-title":"Gynecol Oncol"},{"issue":"3","key":"592_CR6","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1002\/ijc.35440","volume":"157","author":"VM Witjes","year":"2025","unstructured":"Witjes VM, de Hullu JA, Hermkens DMA et al (2025) Nationwide implementation and evaluation of the tumor-first workflow for genetic testing in ovarian carcinoma. Int J Cancer 157(3):504\u2013512. https:\/\/doi.org\/10.1002\/ijc.35440","journal-title":"Int J Cancer"},{"issue":"1","key":"592_CR7","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1155\/2007\/971816","volume":"29","author":"M Casparie","year":"2007","unstructured":"Casparie M, Tiebosch AT, Burger G et al (2007) Pathology databanking and biobanking in the Netherlands, a central role for PALGA, the nationwide histopathology and cytopathology data network and archive. Cell Oncol 29(1):19\u201324. https:\/\/doi.org\/10.1155\/2007\/971816","journal-title":"Cell Oncol"},{"issue":"4","key":"592_CR8","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1007\/s00428-026-04432-2","volume":"488","author":"VM Witjes","year":"2026","unstructured":"Witjes VM, de Hullu JA, van Remortele A et al (2026) Evaluation of homologous recombination testing in ovarian carcinoma. Virchows Arch 488(4):777\u2013788. https:\/\/doi.org\/10.1007\/s00428-026-04432-2","journal-title":"Virchows Arch"},{"issue":"4","key":"592_CR9","doi-asserted-by":"publisher","first-page":"351","DOI":"10.6004\/jnccn.2022.7257","volume":"21","author":"KS Lau-Min","year":"2023","unstructured":"Lau-Min KS, McCarthy AM, Nathanson KL, Domchek SM (2023) Nationwide trends and determinants of germline BRCA1\/2 testing in patients with breast and ovarian cancer. J Natl Compr Canc Netw 21(4):351\u20138.e4. https:\/\/doi.org\/10.6004\/jnccn.2022.7257","journal-title":"J Natl Compr Canc Netw"},{"issue":"1","key":"592_CR10","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1001\/jama.2023.9526","volume":"330","author":"AW Kurian","year":"2023","unstructured":"Kurian AW, Abrahamse P, Furgal A et al (2023) Germline genetic testing after cancer diagnosis. JAMA 330(1):43\u201351. https:\/\/doi.org\/10.1001\/jama.2023.9526","journal-title":"JAMA"},{"issue":"8","key":"592_CR11","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1136\/ijgc-2023-004307","volume":"33","author":"L Lanjouw","year":"2023","unstructured":"Lanjouw L, Mourits MJE, Bart J et al (2023) BRCA1\/2 testing rates in epithelial ovarian cancer: a focus on the untested patients. Int J Gynecol Cancer 33(8):1260\u20131269. https:\/\/doi.org\/10.1136\/ijgc-2023-004307","journal-title":"Int J Gynecol Cancer"},{"issue":"2","key":"592_CR12","doi-asserted-by":"publisher","DOI":"10.1007\/s10689-025-00467-7","volume":"24","author":"L Lanjouw","year":"2025","unstructured":"Lanjouw L, Kramer CJH, Elst AT et al (2025) Evaluation of BRCA1\/2 testing rates in epithelial ovarian cancer patients: lessons learned from real-world clinical data. Fam Cancer 24(2):43. https:\/\/doi.org\/10.1007\/s10689-025-00467-7","journal-title":"Fam Cancer"},{"issue":"1","key":"592_CR13","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.ygyno.2021.10.072","volume":"164","author":"VM Witjes","year":"2022","unstructured":"Witjes VM, van Bommel MHD, Ligtenberg MJL et al (2022) Probability of detecting germline BRCA1\/2 pathogenic variants in histological subtypes of ovarian carcinoma. A meta-analysis. Gynecol Oncol 164(1):221\u2013230. https:\/\/doi.org\/10.1016\/j.ygyno.2021.10.072","journal-title":"Gynecol Oncol"},{"issue":"1","key":"592_CR14","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.ygyno.2022.08.011","volume":"167","author":"K Bokkers","year":"2022","unstructured":"Bokkers K, Frederix GWJ, Velthuizen ME et al (2022) Mainstream germline genetic testing for patients with epithelial ovarian cancer leads to higher testing rates and a reduction in genetics-related healthcare costs from a healthcare payer perspective. Gynecol Oncol 167(1):115\u2013122. https:\/\/doi.org\/10.1016\/j.ygyno.2022.08.011","journal-title":"Gynecol Oncol"},{"key":"592_CR15","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14071638","author":"C Fumagalli","year":"2022","unstructured":"Fumagalli C, Betella I, Rappa A et al (2022) Tumor BRCA testing in epithelial ovarian cancers: past and future-five-years\u2019 single-institution experience of 762 consecutive patients. Cancers (Basel). https:\/\/doi.org\/10.3390\/cancers14071638","journal-title":"Cancers (Basel)"},{"key":"592_CR16","doi-asserted-by":"publisher","DOI":"10.3390\/genes13081398","author":"EA Goebel","year":"2022","unstructured":"Goebel EA, Kerkhof J, Dzyubak O, McLachlin CM, McGee J, Sadikovic B (2022) Examining the diagnostic yield of tumour testing and qualifying germline concordance for hereditary cancer variants in patients with high-grade serous carcinoma. Genes (Basel). https:\/\/doi.org\/10.3390\/genes13081398","journal-title":"Genes (Basel)"},{"issue":"1","key":"592_CR17","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1002\/1878-0261.12817","volume":"15","author":"M Care","year":"2021","unstructured":"Care M, McCuaig J, Clarke B et al (2021) Tumor and germline next generation sequencing in high grade serous cancer: experience from a large population-based testing program. Mol Oncol 15(1):80\u201390. https:\/\/doi.org\/10.1002\/1878-0261.12817","journal-title":"Mol Oncol"}],"container-title":["Familial Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10689-026-00592-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10689-026-00592-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10689-026-00592-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:56:33Z","timestamp":1785826593000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10689-026-00592-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["592"],"URL":"https:\/\/doi.org\/10.1007\/s10689-026-00592-x","relation":{},"ISSN":["1573-7292"],"issn-type":[{"value":"1573-7292","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]},"assertion":[{"value":"15 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no conflict of interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"82"}}