Genetic Testing in Young Adults With Cancer Study

The overarching goal of our research is to define an evidence-based, sustainable approach to identifying and managing genetic risk among young adults with cancer and their relatives. Conventional practice leaves referral and testing decisions to mostly non-expert clinicians implementing complex guidelines at the point of care, leading to substantial under-utilization. The investigators hypothesize that panel-based universal screening coupled with electronic medical record- (EMR-) based algorithms can improve ascertainment of genetic risk by functioning as an automated, radically simplified default practice in place of repeated single decisions requiring clinician cognitive effort and action. A secondary goal is to explore differences in ascertainment of genetic risk among first-degree relatives of probands.

Inclusion Criteria: * Patients will be eligible if they meet the following criteria: * Diagnosed with a solid tumor between age 18-39 (patients may be 40 years of age at time of enrollment) * Within one year of diagnosis with index cancer * Have had at least two visits at Penn Medicine for the cancer diagnosis (to exclude one-time second opinions) Exclusion Criteria: Patients will be excluded if they meet any of the following criteria: * Diagnosis of in situ cancer, thyroid cancer (papillary or follicular), or leukemia Breast cancer diagnosis (aim 1 only) * Have a known genetic predisposition to cancer * Underwent genetic testing after this cancer diagnosis * Have a benign neoplasm