#29-Cancer Genetic Testing Access: Lessons from Point-of-Care & Primary Care

In this episode of DNA Dialogues, we explore two innovative approaches to improving access to genetic testing and hereditary cancer care. First, Daniela Camara and Mariana Niels Swiller discuss UCLA's GENETECA™ program, a point-of-care genetic testing model that integrates cancer genetic services directly into oncology clinics. In the second half of the episode, Tesla Theoryn discusses research examining why many people who express interest in genetic testing never complete the process. The conversation explores how life circumstances, privacy and insurance concerns, changing readiness, and healthcare system barriers influence decision-making over time.   Segment 1: From the ground up: Launching GENETECA™ (GENetic education and TEsting for CAncer) a point-of-care cancer genetics service at an academic medical center   Guest Bios: Daniella Kamara, MS, LCGC is a cancer genetic counselor at University of California, Los Angeles (UCLA). She has been a cancer genetic counselor for over 10 years and works both in the clinical and research settings helping individuals and families who face a hereditary predisposition to cancer. She has contributed to various research studies over the years aiming to increase access to hereditary cancer testing, creating novel models for support for individuals and their family members, and exploring population-based testing models. She is passionate about supporting patients and their family members to feel empowered by their genetic test results and finding ways to make it easier to navigate healthcare for those facing a hereditary predisposition to cancer.    Mariana Niell-Swiller, MS, CGC, is a board-certified genetic counselor with 20 years of experience specializing in hereditary cancer risk assessment. She holds a BS in Biology from Cornell University and an MS in Genetic Counseling from Brandeis University, and began her clinical career after working as a molecular genetics laboratory technician in neurogenetics. She has since held clinical and leadership roles across a range of settings, from community hospitals to academic medical centers. In her current role as Director of Cancer Genetics at UCLA Health, Mariana leads both clinical program development and innovative IT infrastructure to expand access to hereditary cancer services. She is driven by the belief that thoughtfully designed systems can make genomic medicine more scalable, equitable, and sustainable — and is committed to advancing that vision across health systems. Outside of work, she enjoys kayaking, hiking, and dancing, and shares a love of nature with her husband and son. In this segment we discuss: - Increased access to genetic testing for pancreatic cancer patients through a point-of-care model - The benefits and challenges of mainstreaming genetic testing within routine oncology care - How genetic counseling assistants help improve efficiency, scalability, and patient access to cancer genetics services - Lessons learned from implementing GENETECA™ and balancing greater access with the personalized aspects of genetic counseling   Segment 2: Cancer genetic testing uptake in the primary care setting: Patient perspectives on barriers and facilitators throughout the testing process   Guest Bio: Tesla Theoryn, M.Ed., is a qualitative researcher and former high school science teacher with an applied interest in science communication and decision-making in the context of genetic testing. Her work focuses on how medical messaging and timing influence patient engagement and healthcare decisions. She is currently completing her doctorate from the University of Washington in Public Health Genetics. www.linkedin.com/in/teslatheory   In this segment we discuss: - How life circumstances influence uptake of genetic testing - How re-offering genetic testing over time may change uptake as people's priorities, concerns, and readiness change - The impact of privacy, insurance, and legal concerns on genetic testing decisions - Strategies for expanding hereditary cancer screening in primary care while improving equity, accessibility, and patient-centered care Would you like to nominate a JoGC article to be featured in the show? If so, please fill out this nomination submission form here. Multiple entries are encouraged including articles where you, your colleagues, or your friends are authors.   DNA Dialogues has been recognized as a Top 3