The increasing role of genetic counseling in pediatric oncology.
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PURPOSE OF REVIEW: Availability and uptake of somatic and/or germline genetic testing is increasing for children with or at risk for cancer. Diagnosis of a cancer predisposition syndrome (CPS) necessitates long-term oncology care or surveillance. Genetic counseling is imperative to optimize genetic testing for providers and patients/families and to identify and manage those with a CPS. RECENT FINDINGS: In pediatric oncology, genetic counseling aids in patient identification, test selection and/or methodologies, and clinical and psychosocial management of new CPS diagnoses. As a member of a multidisciplinary care team, a genetic counselor is well positioned to provide these services. There is an ongoing shift in pediatric oncology toward universal paired somatic/germline testing at diagnosis, increasing the demand for genetic counseling. Current challenges include limits of testing technology, equitable access to testing and subsequent care, and evolution of CPS diagnoses. SUMMARY: Demand for genetic counseling will only grow as molecular testing is increasingly utilized in pediatric oncology and expands into nontraditional care settings. Genetic counselors will continue to play key roles in identifying patients with CPS, coordinating management in collaboration with a medical team, facilitating patient and family comprehension of a diagnosis, and promoting psychosocial adjustment for those impacted by a CPS.