Effects of cancer type and sex on genetic testing for clinician recommendation and uptake

This study investigated reasons for lower-than-expected uptake of germline genetic testing compared to national guidelines amongst adult patients with cancer, self reporting clinician recommendation for genetic testing. Cross-sectional survey of 596 patients with a personal history of cancer, responded about their cancer diagnosis, physician recommendation for and status of genetic testing and demographics. Adjusting for potential confounding factors (cancer type, education, income and insurance status) male sex significantly decreased odds of receiving a clinical recommendation for genetic testing (Odds Ratio: 0.06; 95% Confidence Interval: 0.04-0.10). Females, with a diagnosis of breast cancer, were more likely to receive a recommendation than other cancer types (64.8% vs. 90.9%, p < 0.001). Participants who received a physician recommendation were significantly more likely to receive genetic testing (p < 0.001). Clinician recommendation is an important driver of genetic testing, necessitating efforts to increase clinician recommendations, particularly for males and patients with cancers other than breast.