{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T17:13:33Z","timestamp":1765041213689,"version":"3.41.2"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T00:00:00Z","timestamp":1642464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>With increased adoption of multi-gene panel testing (MGPT) for hereditary cancer, management guidelines now include a wider range of predisposition genes. Yet little is known about whether MGPT results prompt changes to clinicians\u2019 risk management recommendations and whether those recommendations adhere to guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We assessed cancer risk management recommendations made by clinicians ordering MGPT for hereditary cancer at a diagnostic laboratory using an internet-based survey. We received paired pre- and posttest responses for 2172 patients (response rate\u2009=\u200914.3%). Unpaired posttest responses were received in 168 additional patients with positive results. All tests were 2-sided.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Clinicians reported a change in risk management recommendations for 76.6% of patients who tested positive for a pathogenic or likely pathogenic variant, with changes to surveillance being most common (71.1%), followed by surgical (33.6%), chemoprevention (15.1%), and clinical trial (9.4%) recommendations. Clinicians recommended risk-reducing interventions more often for patients with pathogenic variants in high-risk than moderate-risk genes (P\u2009&amp;lt;\u2009.001), whereas surveillance recommendations were similar for high-risk and moderate-risk genes. Guideline adherence was high for surveillance (86.3%) and surgical (79.6%) recommendations. Changes to risk management recommendations occurred in 8.8% and 7.6% of patients with uncertain and negative results, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Clinicians report frequent changes to cancer risk management recommendations based on positive results in both high-risk and moderate-risk genes. Reported introduction of interventions in patients with inconclusive and negative results is rare and adherence to practice guidelines is high in patients with positive results, suggesting a low probability of harm resulting from MGPT.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jncics\/pkac002","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T15:39:46Z","timestamp":1642001986000},"source":"Crossref","is-referenced-by-count":4,"title":["Clinician-Reported Impact of Germline Multigene Panel Testing on Cancer Risk Management Recommendations"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5186-6208","authenticated-orcid":false,"given":"Carolyn","family":"Horton","sequence":"first","affiliation":[{"name":"Ambry Genetics, Aliso Viejo, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten","family":"Blanco","sequence":"additional","affiliation":[{"name":"Ambry Genetics, Aliso Viejo, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Tzu","family":"Lo","sequence":"additional","affiliation":[{"name":"Ambry Genetics, Aliso Viejo, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Speare","sequence":"additional","affiliation":[{"name":"Ambry Genetics, Aliso Viejo, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3745-9072","authenticated-orcid":false,"given":"Holly","family":"LaDuca","sequence":"additional","affiliation":[{"name":"Ambry Genetics, Aliso Viejo, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3854-9539","authenticated-orcid":false,"given":"Jill S","family":"Dolinsky","sequence":"additional","affiliation":[{"name":"Ambry Genetics, Aliso Viejo, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6175-9470","authenticated-orcid":false,"given":"Allison W","family":"Kurian","sequence":"additional","affiliation":[{"name":"Department of Medicine and of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"issue":"15","key":"2022030906141607100_pkac002-B1","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1200\/JCO.18.01854","article-title":"Genetic testing and results in a population-based cohort of breast cancer patients and ovarian cancer patients","volume":"37","author":"Kurian","year":"2019","journal-title":"J Clin Oncol"},{"issue":"2","key":"2022030906141607100_pkac002-B2","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1038\/s41436-019-0633-8","article-title":"A clinical guide to hereditary cancer panel testing: evaluation of gene-specific cancer associations and sensitivity of genetic testing criteria in a cohort of 165,000 high-risk patients","volume":"22","author":"LaDuca","year":"2020","journal-title":"Genet Med"},{"key":"2022030906141607100_pkac002-B3","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.cancergen.2017.09.003","article-title":"Clinical testing with a panel of 25 genes associated with increased cancer risk results in a significant increase in clinically significant findings across a broad range of cancer histories","volume":"218-219","author":"Rosenthal","year":"2017","journal-title":"Cancer Genet"},{"year":"2020","author":"Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines\u00ae) for Breast\/Ovarian Genetic\/Familial High-Risk Assessment V3.2019. \u00a9 National Comprehensive Cancer Network, Inc","key":"2022030906141607100_pkac002-B4"},{"year":"2020","author":"Referenced with 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