Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 29;17(7):1154.
doi: 10.3390/cancers17071154.

Implementation of a Traceback Testing Program for Ovarian Cancer: Findings from the FACTS Study

Nora B Henrikson  1 , M Cabell Jonas  2 , Paula R Blasi  1 , Adam H Buchanan  3 , Pim Suwannarat  2 , Kathleen Leppig  4 , Aaron Scrol  1 , Tracey Leitzel  3 , Adrienne N Deneal  2 , Daniela Canedo  2 , Arvind Ramaprasan  1 , Sundeep S Basra  2 , Jennifer Brown  2 , Marilyn Odums  2 , Yirui Hu  3 , Katrina M Romagnoli  3 , Estella Khieu  5 , Elsa Balton  4 , Saumya Patel  3 , Muki Kunnmann  3 , Dina Hassen  3 , Jing Hao  3 , Meredith Lewis  3 , Rachel Schwiter  3 , Jessica Goehringer  3 , Heather M Ramey  3 , Shanshan Gustafson  2 , Katrina Hsieh  2 , Ilene Ladd  3 , Alanna K Rahm  3
Affiliations

Implementation of a Traceback Testing Program for Ovarian Cancer: Findings from the FACTS Study

Nora B Henrikson et al. Cancers (Basel). .

Abstract

Background: Traceback testing-identifying and offering testing to people with previous cancer diagnoses who have not received current standard genetic testing-could benefit patients and their at-risk relatives.

Methods: We conducted a multisite, nonrandomized pilot implementation study of a Traceback program at three integrated United States health systems. We assessed the reach, fidelity, effectiveness, and acceptability of the program using quantitative and qualitative methods.

Results: We identified 597 eligible individuals using administrative data and manual chart review. We attempted to reach everyone identified (100% fidelity). We successfully contacted 354 people, for a reach of 59% of confirmed eligible individuals. In total, 133 people completed Traceback genetic testing. Ten of these (8%) received pathogenic or likely pathogenic results;. Nine of these ten people received positive results for which cascade testing of at-risk relatives would be indicated. None of their relatives underwent cascade testing during the study period. Thirty-six received variants of uncertain significance (VUS). Traceback programs were acceptable to participants and implementers and thought to be applicable to other genetic screening conditions. The time and resources required to accurately identify Traceback-eligible individuals are likely determinants of future sustainability.

Conclusions: Education about free cascade testing, reminder calls to probands, and offers to directly contact at-risk relatives did not result in cascade testing in this pilot study. However, participant and implementer discussions suggest that the potential benefits of Traceback programs and high participant acceptability are worthy of further study.

Keywords: cancer prevention; gynecologic cancer risk reduction; ovarian cancer.

PubMed Disclaimer

Conflict of interest statement

Jessica Goehringer has a family member with equity in Genomic Life. All other authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Overview of Traceback testing programs at each site.
See this image and copyright information in PMC

References

    1. Siegel R.L., Giaquinto A.N., Jemal A. Cancer statistics, 2024. CA Cancer J. Clin. 2024;74:12–49. doi: 10.3322/caac.21820. - DOI - PubMed
    1. Eccles D.M., Balmaña J., Clune J., Ehlken B., Gohlke A., Hirst C., Potter D., Schroeder C., Tyczynski J.E., Gomez Garcia E.B. Selecting Patients with Ovarian Cancer for Germline BRCA Mutation Testing: Findings from Guidelines and a Systematic Literature Review. Adv. Ther. 2016;33:129–150. doi: 10.1007/s12325-016-0281-1. - DOI - PubMed
    1. Kuchenbaecker K.B., Hopper J.L., Barnes D.R., Phillips K.A., Mooij T.M., Roos-Blom M.J., Jervis S., van Leeuwen F.E., Milne R.L., Andrieu N., et al. Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers. JAMA. 2017;317:2402–2416. - PubMed
    1. Daly M.B., Pal T., Maxwell K.N., Churpek J., Kohlmann W., AlHilli Z., Arun B., Buys S.S., Cheng H., Domchek S.M., et al. NCCN Guidelines(R) Insights: Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 2.2024. J. Natl. Compr. Canc Netw. 2023;21:1000–1010. - PubMed
    1. Rebbeck T.R., Kauff N.D., Domchek S.M. Meta-analysis of risk reduction estimates associated with risk-reducing salpingo-oophorectomy in BRCA1 or BRCA2 mutation carriers. J. Natl. Cancer Inst. 2009;101:80–87. - PMC - PubMed

LinkOut - more resources