{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:59:26Z","timestamp":1790715566326,"version":"4.1.0"},"reference-count":44,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Despite the potential for substantial public health impact of cascade genetic testing (CGT), few at-risk relatives complete testing. We compared facilitated CGT with standard of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Probands with newly diagnosed\n                      <jats:italic toggle=\"yes\">BRCA1\/2<\/jats:italic>\n                      germline pathogenic variants were cluster-randomized to a facilitated cascade testing intervention or standard care. Random assignment occurred at the proband level and was stratified by personal cancer history, the number of first-degree relatives (FDRs; 1-2\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      \u22653), and time since genetic testing (\u22646 months\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      &gt;6-12 months). Adult FDRs without prior testing per self-report were enrolled. The intervention included navigation support and access to genetic testing services; control FDRs received a letter, consistent with standard clinical practice. Free germline genetic testing was available to all FDRs regardless of arm assignment. The primary outcome was completion of genetic testing at 6 months, compared using a two-sided Cochran-Mantel-Haenszel test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Among 151 probands with\n                      <jats:italic toggle=\"yes\">BRCA1<\/jats:italic>\n                      (52%)\n                      <jats:italic toggle=\"yes\">or BRCA2<\/jats:italic>\n                      (48%) pathogenic variants, 72% had a prior cancer diagnosis. Probands were randomly assigned, with 142 and 144 FDRs assigned to the intervention and control arms, respectively. At 6 months, genetic testing uptake was significantly higher among FDRs in the intervention group compared with the control group (73.2% [adjusted 95% CI, 64.4 to 82.1]\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      50.7% [adjusted 95% CI, 41.0 to 60.4];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). By 18 months, 90% of intervention FDRs completed genetic testing. Among 206 FDRs who completed testing, 95 (46%) were found to have a pathogenic or likely pathogenic variant; of these, 82 (86%) carried the familial variant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      In this randomized trial, facilitated CGT significantly increased genetic testing uptake among FDRs of probands with\n                      <jats:italic toggle=\"yes\">BRCA<\/jats:italic>\n                      <jats:italic toggle=\"yes\">1\/2<\/jats:italic>\n                      pathogenic variants compared with standard care.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-26-00735","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:59:11Z","timestamp":1790711951000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Facilitated Cascade Genetic Testing for Relatives of Individuals With\n                    <i>BRCA1\/2<\/i>\n                    Pathogenic Variants: A Randomized Controlled Trial"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6176-9441","authenticated-orcid":false,"given":"Roni Nitecki","family":"Wilke","sequence":"first","affiliation":[{"name":"Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0563-1579","authenticated-orcid":false,"given":"Haley A.","family":"Moss","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology at the Duke University Medical Center, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7306-5081","authenticated-orcid":false,"given":"Maria D.","family":"Iniesta","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1632-1864","authenticated-orcid":false,"given":"Xun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Linhart","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology at the Duke University Medical Center, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6905-9823","authenticated-orcid":false,"given":"Ravi N.","family":"Sharaf","sequence":"additional","affiliation":[{"name":"Genetics and Personalized Cancer Prevention Program, Weill Cornell Imaging at New York Presbyterian Hospital, New York, NY"},{"name":"Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY"},{"name":"Division of Gastroenterology, Department of Medicine, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0654-0863","authenticated-orcid":false,"given":"Alexander","family":"Melamed","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5317-9927","authenticated-orcid":false,"given":"Karen H.","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Moffitt Cancer Center &amp; Research Institute, Tampa, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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