- Design
- Three-arm randomised clinical trial
- Population
- 793 adults meeting criteria for germline cancer testing, never tested
- Primary outcome
- Completion of genetic testing by 6 months
- Effect
- Digital AOR 3.88 (1.27 to 14.80) at 6 months; coaching AOR 2.25 at 12 months
The MiGHT trial in Michigan randomised 793 adults who met national criteria for germline cancer genetic testing but had never been tested to telephone health coaching, a self-directed digital programme, or usual care. Both interventions used genetics education and motivational interviewing.
Only 4.9% overall completed testing by six months and 9.6% by twelve. Compared with usual care, the digital programme raised the odds of testing by six months (adjusted OR 3.88, 97.5% CI 1.27 to 14.80), and coaching raised the odds by twelve months (2.25, 1.11 to 4.77). Both raised intention to test.
The wide intervals reflect how few people were tested in any arm. Even with help, nine in ten eligible people remained untested at a year — a reminder that identifying eligibility is the easy step, and arranging the test needs to happen in the same encounter where possible.
- Take a three-generation family history of cancer at diagnosis and at key follow-up visits
- Offer germline testing directly where eligible, rather than relying on a separate referral
- Use written or digital education to support the decision, not replace the offer
- Follow up on whether testing actually happened
Why it matters
Missed germline results change treatment, screening and family risk, and most eligible people are never tested.
Don't overread it
Testing was self-reported and overall uptake stayed below one in ten even with the interventions.
The statistics, in plain English
An odds ratio of 3.88 sounds large, but with very few tests in any group the interval stretches from 1.27 to 14.80. The direction is likely right; the size is uncertain.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for oncology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free