In a recent interview with Urology Times®, Veda N. Giri, MD, outlined some of the key barriers to genetic testing in prostate cancer, which were outlined in a recent review on the current state of germline testing in the field.1
Giri is a professor of internal medicine in medical oncology, the director of the Cancer Genetics and Prevention Program at Yale Cancer Center Smillow Cancer Hospital, and the director of the Early Onset Cancer Program at Yale Cancer Center in New Haven, Connecticut.
One major challenge is the shortage of genetic counselors. Giri noted that alternative delivery models for counseling are being explored to address the high patient volume. Financial barriers also exist: insurance coverage for testing varies, and while out-of-pocket costs in the U.S. have dropped significantly, coverage remains inconsistent.
Giri also addressed another important consideration: insurance discrimination. The US Genetic Information Nondiscrimination Act (GINA) protects against discrimination in health insurance and employment, but it does not cover life, disability, or long-term care insurance2—an issue that must be discussed with patients to ensure informed decisions and financial preparedness.
REFERENCES
1. Loeb S, Vadaparampil ST, Giri VN. Germline testing for prostate cancer: current state and opportunities for enhanced access. EBioMedicine. 2025:116:105705. doi:10.1016/j.ebiom.2025.105705
2. The Genetic Information Nondiscrimination Act (GINA). American Society of Human Genetics. Accessed October 1, 2025. https://www.ashg.org/advocacy/gina/