The Clinical Application of Refined Risk Estimates (caRe) Study in BRCA1 and BRCA2 Pathogenic Variant Carriers: A Randomized Controlled Trial

Randomized trial comparing genotype-informed risk estimates to standard estimates on decisional conflict

This two-arm randomized trial tested, in women carrying a BRCA1/2 pathogenic variant, whether genotype-informed cancer risk estimates (GRE) reduced decisional conflict related to management, compared to standard lifetime risk estimates (SRE). No difference in decisional conflict was observed between arms at follow-up. The SRE arm did show decreased decisional conflict and increased perceived stress versus baseline. A more personalized risk estimate therefore did not reduce decisional conflict in BRCA1/2 carriers.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

An instructive and somewhat counterintuitive result: further individualizing risk estimates does not reduce decisional conflict, which should make us cautious about the idea that “more numerical precision” mechanically improves the consultation experience. The mediation of genetic counseling remains central, beyond the risk figure alone. Useful data for structuring our oncogenetics consultations.