Parental communication with their children about cancer risk and DTC cascade genetic testing: Implications for genetic education and counseling Journal Article


Authors: Sleiman, M. M. Jr; Zamir, T.; Peshkin, B. N.; Hamilton, J. G.; Liu, M.; Yockel, M. R.; Wilfond, B.; Ross, L. F.; Brower, J.; Ovadia, H.; Sacca, R.; Tarini, B.; Domchek, S. M.; Isaacs, C.; Tercyak, K. P.
Article Title: Parental communication with their children about cancer risk and DTC cascade genetic testing: Implications for genetic education and counseling
Abstract: Cascade genetic testing for cancer risk can influence relatives' health outcomes, as they may benefit from risk reduction and screening. However, clinical guidelines discourage predictive genetic testing in childhood—including direct-to-consumer (DTC) testing. This study examined high-risk parents' preparation of their children (primarily adolescents and young adults) for cascade genetic testing for adult-onset inherited cancers. Surveys were completed by N = 126 parents with pathogenic variants predisposing to adult-onset inherited cancers included on DTC testing panels. A total of 81% of children were aware of their parents' hereditary cancer predisposition and 62% of parents had discussed their children's participation in cancer genetic testing. Potential risks of DTC testing identified by parents included lack of engagement with clinicians; potential benefits were its usefulness for child/family health and convenience. Parents with older children (B = 0.07, p = < 0.001), greater confidence in using genetic information (B = 0.02, p < 0.05), and who held more favorable opinions about pediatric genetic testing (B = 0.02, p < 0.01) were more likely to make their children aware of their familial cancer risk and discuss cascade testing. Most high-risk parents discuss hereditary cancer and testing options with their older children. Research is needed to enrich understanding of healthcare professionals' roles in navigating the implications of cascade genetic testing choices within the family, including DTC testing. © 2025 The Author(s). American Journal of Medical Genetics Part A published by Wiley Periodicals LLC.
Keywords: children; genetic testing; cancer
Journal Title: American Journal of Medical Genetics Part A
ISSN: 1552-4825
Publisher: Wiley Liss, Inc  
Publication status: Online ahead of print
Date Published: 2025-05-13
Online Publication Date: 2025-05-13
Start Page: e64115
Language: English
DOI: 10.1002/ajmg.a.64115
PROVIDER: scopus
PUBMED: 40357860
DOI/URL:
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- Source: Scopus
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MSK Authors
  1. Jada Gabrielle Hamilton
    113 Hamilton
  2. Rosalba Sacca
    8 Sacca
  3. Hannah Sarah Ovadia
    5 Ovadia