Universal Germline Genetic Testing after a Diagnosis of Cancer.

Germline pathogenic variants are most prevalent in early-onset cancer patients, with 18.4% in early-onset tumors compared to 12.3% in late-onset tumors, across 32 tumor types.

• Why it matters: Age-based criteria for hereditary cancer testing may overlook many individuals with inherited risk, risking missed opportunities for prevention and targeted treatment.
• What they did: Germline sequencing of 39,184 unselected cancer patients was performed, stratifying them into early-, average-, and late-onset groups based on tumor-specific age at diagnosis, analyzing >90 cancer predisposition genes.
• The result: Restricting testing to patients diagnosed before age 50 would miss 4,601 pathogenic variant carriers, representing 72% of all detected variants, supporting universal germline testing for all cancer patients.