Can Digital Tools and Phone Coaching Improve Cancer Genetic Testing Rates?
Inherited genetic variants account for approximately 10% of all cancer cases. Despite this significant link, only a small fraction of cancer patients who are eligible for genetic testing actually complete the evaluation. While clinical guidelines identify patients who could benefit from understanding their genetic risks, real-world completion rates remain low, with studies showing that as few as one in fifteen eligible individuals successfully undergo testing.
Understanding the Barriers to Genetic Testing
Researchers point out that multiple obstacles prevent patients from completing recommended genetic evaluations. Common hurdles include limited access to specialized clinics, financial costs, privacy concerns, and general anxiety about what the results might reveal. Furthermore, experts note that a primary barrier is a fundamental lack of knowledge regarding how genetic testing works and why it matters for cancer prevention or treatment.
When individuals test positive for specific genetic variants linked to increased cancer susceptibility, clinicians can design personalized screening schedules to detect malignancies earlier. For patients who have already received a cancer diagnosis, genetic test results can help guide targeted treatment choices. However, bridging the gap between clinical eligibility and actual testing has proven challenging.
Evaluating Digital Interventions and Phone Support
To address these hurdles, a team of investigators at the University of Michigan Rogel Cancer Center conducted the Michigan Genetic Hereditary Testing trial, known as MiGHT. The randomized clinical trial investigated whether scalable educational strategies could increase testing rates among adults who met clinical criteria based on their personal or family medical history.
The study engaged 793 adult participants from across Michigan. Researchers randomized the participants into three separate groups:
- A group receiving phone-based health coaching incorporating motivational interviewing concepts
- A group assigned a self-directed digital intervention providing online education about genetics
- A control group receiving standard care
The intervention materials were designed to deliver targeted education while using motivational messaging to help participants overcome psychological and informational barriers.
Study Findings and Limitations
The research team tracked participants at six-month and one-year intervals. Overall, 5% of all participants completed genetic testing after six months, and 10% completed testing by the one-year mark. Individuals who received either the digital tool or the phone-based coaching showed a greater likelihood of completing genetic testing or expressing an intention to seek testing compared to those in the usual care group.
Despite these improvements, the study authors emphasize that overall testing uptake remained modest. Investigators noted that simply providing educational knowledge is often insufficient to overcome the logistical hurdles of scheduling appointments and discussing results with physicians. Additionally, the study period of one year may still be too short to capture the full impact of the interventions, as patients often require extended time to process complex genetic information and arrange clinical follow-up.
Looking ahead, researchers suggest that future approaches must offer tailored solutions, recognizing that some individuals prefer independent digital resources while others benefit from personal phone conversations. Investigators across multiple National Cancer Institute-funded projects continue to analyze findings to determine the most effective ways to improve access, refine referral pathways, and support patients through the genetic testing process.
