23: Returning Additional Findings in the 100,000 Genomes Project

Stafford-Smith B et al., Genetics in Medicine - Mixed-methods evaluation of how 100,000 Genomes Project participants experienced receiving positive additional findings (PAFs) for cancer or familial hypercholesterolaemia and no additional findings (NAFs), with implications for clinical return pathways and patient support. Key terms: genome sequencing, additional findings, secondary findings, participant experiences, familial hypercholesterolemia.

Study Highlights:
This convergent mixed-methods study surveyed 147 PAF recipients and conducted interviews with 35 PAF and 29 NAF participants across 18 NHS sites. Most participants found AF results useful, expected to act on recommendations, and shared results with family, though cancer PAFs caused more initial shock and distress than FH PAFs. NAF recipients were generally relieved but some misunderstood the scope and limitations of the result and wanted follow-up. Participants supported offering AFs when optional and actionable, while recommending tailored communication and timely clinical support.

Conclusion:
Patient experiences were largely positive and supportive of routinely offering actionable additional findings, but practice should include clearer communication for NAF recipients, condition-tailored approaches, and timely, tailored clinical support for those with positive findings.

QC:
This episode was checked against the original article PDF and publication metadata for the episode release published on 2025-05-17.

QC Scope:
- article metadata and core scientific claims from the narration
- excludes analogies, intro/outro, and music

QC Summary:
- factual score: 10/10
- metadata score: 10/10
- supported core claims: 7
- claims flagged for review: 0
- metadata checks passed: 4
- metadata issues found: 0

Metadata Audited:
- article_doi
- article_title
- article_journal
- license

Factual Items Audited:
- Returning secondary findings is valued by patients and support for routine offering when actionable.
- Cancer-associated AFs produce higher distress than FH-associated AFs.
- No findings (NAF) results are generally positive but can be misunderstood, requiring additional education and follow-up.
- Decisional regret about AFs is generally low and high-regret instances decline after plan development and support.
- A large proportion share AF results with family to enable cascade testing.
- Clinical pathways for AFs must be tailored by condition; a one-size-fits-all approach is insufficient.

QC result: Pass.