Balancing benefits, costs, and harms: policy implications of expanding cancer susceptibility testing from genetics clinics to the general population.

Expanding cancer susceptibility testing beyond genetics clinics to the general population requires a careful, context-specific approach due to uncertain evidence for many genes and risk scores.

• Why it matters: Widespread implementation of cancer susceptibility testing is advancing faster than the evidence supporting its clinical and public health benefits, especially in well populations, raising concerns about effectiveness and resource use.
• What they did: The authors review the current evidence for well-established genes like BRCA1/2 and newer genes with uncertain risk estimates, along with polygenic risk scores, emphasizing the need for a tiered, context-specific implementation strategy.
• The result: A careful, tiered approach could help identify settings where testing offers a net benefit, while restricting or reserving it for research in scenarios with uncertain or limited evidence.