Genetic Testing Station Provides Increased Access to Germline Genetic Testing for Pediatric Oncology Patients

Germline genetic testing in the pediatric oncology population remains under-utilized, despite evidence that 10%-15% of these patients have an underlying genetic cause. Identifying patients with a genetic predisposition can affect diagnosis, treatment, and future surveillance of the patient and family. Genetic testing station (GTS) is an educational video for patients and families describing genetic testing. This study tested the effect of GTS compared to in-person counseling on the rate of germline genetic testing, genetic testing knowledge, and decisional conflict in a diverse patient setting. Participants recruited from the pediatric solid tumor service received counseling via GTS, while participants recruited from the multidisciplinary cancer predisposition program received in-person counseling. Participants completed surveys on genetic testing knowledge, health literacy, and psychosocial impact before and after genetic counseling. Baseline rates of pediatric genetic testing were established via chart review. There were 28 participants in the GTS arm and 11 in the in-person counseling arm. The arms had similar ethnic and racial backgrounds and rates of health literacy. There was no significant difference in the change in genetic testing knowledge pre- and post-intervention in the two arms individually or between the two arms of the study. There were significantly higher rates of germline genetic testing with the introduction of GTS compared to baseline rates in the pediatric oncology population. Our study demonstrates that GTS is a feasible approach to provide pre-test genetic counseling in a pediatric solid tumor clinic and may be an alternative to in-person counseling. Its implementation led to an increase in germline genetic testing rates in the pediatric solid tumor program.