Abstract Background. Cancer genetic counseling and testing (GCT) remains severely underutilized largely due to its delivery being limited primarily to highly-resourced oncology settings, which few access. We have little knowledge of efforts to implement GCT in non-oncology settings. Implementing GCT in non-oncology settings could significantly expand GCT access and reduce the burden of cancer. Aims. This systematic review describes recent research on the delivery of GCT in non-oncology settings. Methods. We conducted systematic searches of PubMed, Embase, and PsycINFO to identify eligible studies published between September 2019 and May 2025. Studies were eligible if they were: conducted in non-oncology settings, employed cancer genetic risk screening based on personal or family history of cancer, and reported uptake of either cancer genetic risk screening, genetic counseling, or genetic testing. Key extracted data were on: study setting, study sample, uptake (of screening, counseling, and testing separately), description of intervention, description of intervention components (for screening, counseling, and testing separately) and their frequencies. We utilized the 16-item QATSDD for quality assessment and reporting adheres to PRISMA guidelines. Results. Seventeen studies met our inclusion criteria. The majority were conducted in clinical settings (60%; e.g. primary care, imaging centers), with others in non-clinical community (24%) or registry (12%) settings. Only five samples (29%) were low socioeconomic status. Family history screening (41%) and genetic testing (65%) were more often the foci of studies than counseling (24%). Uptake rates varied from 19% to 100% for screening, 6% to 68% for genetic counseling and 5% to 100% for genetic testing. Among studies involving family history screening, 80% used universal screening, 60% an electronic screener, 47% a validated screener, and 40% integrated the screener with existing workflows. Notably, 93% included patient education as a component of screening. Patient self-administration (67%) was more common than staff (33%) and medical provider-administration (13%). Point of contact screening (60%) was slightly more common than asynchronous screening (47%). In studies that included genetic counseling, 44% employed tele-delivery, 33% navigation, and only 22% free counseling. Among testing-focused studies, 50% followed a traditional referral model (pre-test counseling required), while 50% adopted alternative, streamlined models allowing direct access to testing. Patient education, at-home test kits, and free testing were more frequently employed in community-based studies than in clinical settings. Discussion and Implications. Given overall suboptimal uptake of genetic risk screening, counseling and testing, research evaluating which intervention components promote greatest uptake of GCT in non-oncology settings is needed. Conclusion. An alternative model for GCT delivery in non-oncology settings is needed, particularly for downstream access to counseling and testing, beyond initial risk screening. Citation Format: Maisha R. Huq, Osezimen (David) Uhomoibhi, Priya Meesa, Alejandra Hurtado de Mendoza, Chiranjeev Dash, Marc D. Schwartz. Expanding access to cancer genetic services beyond the traditional oncology setting: A systematic review abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B077.
Huq et al. (Thu,) studied this question.