Abstract 6375: Genetic testing station increases access to germline genetic testing
Authors: Hamilton Camille , Swiller Mariana Niell , Bhansali Franceska , Hoover Alyssa , Bottomley Stephanie , Lewis Marisa , Russell Bianca , Martinez Julian A. , Karlan Beth , Federman Noah , Chang Vivian Y. 
Published: March 2024

Abstract
Despite evidence of clear benefit, genetic testing of pediatric oncology patients for germline variants remains rare due to a variety of factors, including insurance/financial barriers, limited knowledge about genetic testing, and competing interests for time and resources. Limited access to genetic testing, pre-test counseling and multidisciplinary care have been shown to disproportionately affect patients with limited resources. This represents a critical unmet need in pediatric oncology. Genetic testing station (GTS) is a pre-test counseling video tool that reviews what genetic testing is, why it might be indicated, and explains potential results. Similar video tools have been successfully used in other settings to increase rates of genetic testing, but there are no published reports on the effectiveness of a video education intervention to increase genetic testing in pediatric oncology patients. To test the effectiveness of GTS on genetic testing knowledge and feelings about genetic testing compared to in-person counseling, we use 5 previously validated tools pre- and post-intervention. The initial surveys measure genetic testing knowledge, decisional conflict, healthy literacy, evaluation of GTS and demographics. If participants complete genetic testing, we use the MICRA to assess the impact on their cancer risk assessment. Our GTS arm is recruited from UCLA Pediatric Sarcoma patients, and the in-person counseling arm is recruited from the UCLA Cancer Predisposition clinic. We have recruited 28 participants in the GTS arm and seven in the in-person counseling arm, of which 10 are patients over 18 years old, two are patients between 12-17 years old, and 23 are parents. In our GTS arm, there are 20 female and eight male participants. A majority identify as white or Latino. For the in-person counseling arm, there are four male and three female participants who identify as white, Middle Eastern, or Latino. A similar percentage score with high health literacy, 68% in the GTS arm and 71% for the in-person counseling arm. The majority of patients have no decisional conflict pre- or post-intervention for the GTS group, while the in-person counseling arm shows high initial decision conflict that is fully resolved with counseling. There is a statistically significant increase in genetic testing knowledge for five out of 10 questions comparing pre- and post-GTS. For GTS participants who have completed genetic testing and the MICRA, there is overall low distress and uncertainty, but higher scores for parents than adult or minor patients. In conclusion, there has been high interest in germline genetic testing in pediatric oncology patients with all families deciding to pursue genetic testing after viewing GTS. GTS is an effective tool in increasing genetic testing knowledge in participants. Therefore, GTS is a promising approach to increase access to genetic testing, while providing adequate pre-test counseling and no decisional conflict.
Citation Format: Camille Hamilton, Mariana Niell Swiller, Franceska Bhansali, Alyssa Hoover, Stephanie Bottomley, Marisa Lewis, Bianca Russell, Julian A. Martinez, Beth Karlan, Noah Federman, Vivian Y. Chang. Genetic testing station increases access to germline genetic testing [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6375.