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New research from CORE and Providence Genomics asks whether how and where genetic testing is offered affects whether patients say “yes.” 

Portland, Ore. -- April 29, 2026 -- Genetic testing has the potential to transform health care through earlier disease detection, tailored prevention, and more precise treatments. However, this technology is new to many patients and providers, and participation in genetic testing remains low. Despite national guidelines, less than 20 percent of eligible U.S. patients with a personal or family history of breast or ovarian cancer get genetic testing. Participation also varies by age, race, and insurance status.

How can health systems close those gaps? A new study from CORE and Providence Genomics examined two practical levers: the methods used to invite patients to participate in genetic testing and the location where testing is offered.

Read key takeaways from the study below. Or check out the full paper at Frontiers in Cancer Control and Society. This study was made possible by funding from the Investigator-Initiated Studies Program of Merck Sharp & Dohme LLC. 

Outreach methods: different channels, similar results

This part of the study examined three outreach methods for inviting patients to get genetic testing. CORE contacted 7,112 patients at an elevated risk for cancer who neither declined nor immediately opted for genetic testing at their mammogram appointment. Patients were sent an email, a mailed brochure, or an SMS text message one to three months after a mammogram appointment at one of eight California clinics. 

While overall uptake after outreach was low—less than 3%—our finding that this figure didn’t meaningfully differ between outreach methods offers an important takeaway for health systems and providers: investing in lower-cost, scalable approaches like email may be just as effective as more costly print mailers.

Access matters: offering convenient, on-site testing increased participation

Ease of access, on the other hand, made a notable difference.

Additional analysis revealed that patients were significantly more likely to opt in when offered genetic testing on the same day and in the same building as their mammogram, rather than having to go elsewhere. After controlling for demographic differences, the testing rate among patients offered testing in the same building was 28 percent higher than that of patients who would have to go to a different building.

“This study showed that offering testing at the point of care can significantly improve follow-through,” explains Emily Bryce, PhD, Associate Research Scientist at CORE. “Patients were more likely to participate in this testing when it was part of the visit, rather than at another location that took time to travel to and find.”

Opportunities to improve testing equity

The study also revealed demographic differences in genetic testing participation.  

Overall, patients under 45 were more likely to participate than older patients. Individuals of Asian race/ethnicity had a 20 percent lower genetic test order rate than White non-Hispanic individuals. And those using a language other than English in the assessment that determines genetic test eligibility had a 44 percent lower order rate than those using English. 

Clear gaps emerged when getting a genetic test meant going to another building. No patients who preferred a language other than English ordered a test when required to go to another building. However, when testing was available on site, there were no differences by preferred language. The study also saw that Black and Asian patients at the clinics that did not offer testing in the same building were less likely to have tests ordered. However, in clinics where everything happened in one place, testing rates were similar across racial and ethnic groups.

These findings further emphasize the impact of offering convenient, on-site genetic testing at the point of care and equitable access to genetic testing.

Moving ahead

This work adds to the growing body of research on how best to implement and expand the reach of cancer genetic testing services into routine care. While the outreach methods in this study may not be sufficient to drive increased testing at scale, steps to ease access to testing at the point of care can have a significant impact.

Going forward, future research could examine how different phrasing or language used to talk about genetic testing in outreach may influence uptake and methods to improve facility and provider capacity to offer point-of-care genetic testing in routine settings.

Read more in Frontiers in Cancer Control and Society

Related news & resources

• CORE's 2025 Annual Report
• Unlocking the promise of PGx: Insights from CORE
• Navigating the path of genomic medicine: Insights from an early detection program