Barriers to Genetic Counselling and Testing among Breast and Ovarian Cancer Patients in low Low-Middle-Income Country Referral Hospital - A Prospective Study

Background Breast and ovarian cancers pose significant health burdens in India, with hereditary cases contributing to disease incidence. Genetic counselling (GC) and genetic testing (GT) are essential for risk assessment and management, yet their utilization remains limited. This study evaluates barriers to GC and GT among breast and ovarian cancer patients in a low-middle-income country (LMIC) referral hospital. Methods A prospective study was conducted at a tertiary care hospital in South India. Newly diagnosed breast and ovarian cancer patients were screened for GC and GT eligibility based on modified NCCN guidelines. Patients underwent counseling, testing, or were interviewed regarding barriers to uptake. Statistical analysis was performed using SPSS 22.0. Results Among 120 eligible patients, 42% underwent GT, while 49% declined both GC and GT. The primary barrier was financial constraints (52%), followed by emotional burden concerns (18%), lack of awareness (16%), and social stigma (9%). Pathogenic mutations were detected in 40% of tested patients, with BRCA mutations being most common. Conclusion Despite decreasing GT costs, financial burden remains a major barrier. Addressing economic, educational, and social factors is crucial to improving genetic service utilization and enhancing cancer management in LMIC settings.