Let clinics contact relatives directly when a cancer gene is found
When someone tests positive for a BRCA or Lynch mutation, relatives are told only if the patient passes the message on. Most do not. Letting clinics contact relatives directly, with consent, could double testing.
Cascade testing uptake is 20-40%. Trials of health-system-initiated direct contact (with proband consent) in the Netherlands and Australia show higher uptake. Propose direct contact as the default, with digital family letters, telegenetic counselling, and free mail-in testing for relatives regardless of their insurer.
- Inherited risk is mostly unidentified · Most people who carry a high-risk cancer gene do not know it until they or a relative gets cancer.
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