Improving genetic diagnosis of hereditary tumor syndromes: From expanded gene panels to functional genomics

Genetic tumor risk syndromes (genturis) contribute substantially to the overall cancer burden and provide opportunities for early detection, prevention, and individualized treatment. Yet, many affected individuals remain undiagnosed due to restrictive testing criteria and challenges in variant interpretation. This review summarizes recent advances in the diagnostic evaluation of genturis. We trace the evolution from single-gene testing to multigene panel testing, highlighting gains in diagnostic yield alongside the growing prevalence of uncertain and incidental findings. We then describe emerging functional approaches such as RNA sequencing and proteomics that generate molecular evidence to refine variant classification. Next, we outline how long-read sequencing overcomes technical limitations in complex genomic regions. Finally, we discuss practical aspects of clinical implementation, including reporting practices, workflow integration, and professional education, and propose strategies to improve diagnostic accuracy, efficiency, and equitable access to testing.