Abstract 1447: Feasibility of a traceback approach to facilitate genetic testing in the Genetic Risk Analysis in Ovarian Cancer (GRACE) Study
Authors: Feigelson Heather S. , Prado Yolanda K. , Kauffman Tia , Reyes Ana A. , Zepp Jamilyn M. , Maiyani Mahesh , Sawyer Jennifer , White Larissa L. , Salas S. Bianca , Vertrees Sarah , Rope Alan F. , Weinmann Sheila , Henrikson Nora B. , Lee Sandra S. , Hunter Jessica E. 
Published: June 2022

Abstract
Current guidelines state that genetic testing is clinically indicated for all individuals diagnosed with ovarian cancer. Individuals with a prior diagnosis of ovarian cancer who have not received genetic testing represent missed opportunities to identify individuals with inherited high risk cancer variants. The Genetic Risk Assessment in Ovarian Cancer (GRACE) study aims to address this significant healthcare gap using a “traceback testing” approach to identify individuals with a prior diagnosis of ovarian cancer and offer genetic risk information to them and their family members. Tumor registry data at two integrated health care systems (Kaiser Permanente Northwest and Kaiser Permanente Colorado) was used to identify individuals diagnosed with ovarian cancer from 2008 to 2019 who either did not receive genetic testing or had genetic testing limited to BRCA1 and BRCA2 and could benefit from more recent testing and testing using a comprehensive panel of cancer risk genes. Of the 180 eligible individuals contacted for participation, 51 have enrolled and consented to testing, reflecting an uptake rate of 28%. Of the 34 participants with genetic testing results, 7 (21%) have been found to carry a pathogenic or likely pathogenic variant in a cancer risk gene. The study genetic counselor supported these participants in sharing their genetic test results with at-risk relatives to facilitate cascade testing. Of the 20 at-risk relatives eligible for cascade testing, 10 have undergone genetic testing (50% cascade testing uptake) of which 4 have been found to carry the familial variant. Overall, these findings indicate the promise of such traceback testing approaches in providing potentially life-saving information to individuals and their family members at increased genetic risk for cancer who may otherwise be missed. Future efforts of the GRACE study will focus on the feasibility of leveraging archived pathology tissue to provide genetic risk information to family members of individuals with a diagnosis of ovarian cancer who are deceased. The GRACE study can inform broad implementation of future traceback programs across health care systems, providing life-saving information to prevent and mitigate the burden of ovarian and other hereditary cancers.
Citation Format: Heather S. Feigelson, Yolanda K. Prado, Tia Kauffman, Ana A. Reyes, Jamilyn M. Zepp, Mahesh Maiyani, Jennifer Sawyer, Larissa L. White, S. Bianca Salas, Sarah Vertrees, Alan F. Rope, Sheila Weinmann, Nora B. Henrikson, Sandra S. Lee, Jessica E. Hunter. Feasibility of a traceback approach to facilitate genetic testing in the Genetic Risk Analysis in Ovarian Cancer (GRACE) Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1447.