Brief report: attitudes and barriers toward genetic testing in pleural mesothelioma: a nationwide Italian survey

Our plain-English summary of Brief report: attitudes and barriers toward genetic testing in pleural mesothelioma: a nationwide Italian survey, by L. Cerbone, M. Perrino, F. Grosso, et al (Familial Cancer, 2026).

The study

• Authors: L. Cerbone, M. Perrino, F. Grosso, M. Ganzinelli, G. Lo Russo, G. Pasello, P.A. Zucali, G.L. Ceresoli, M. Occhipinti, M. Sculco, on the behalf of MET-I (Mesothelioma team Italy)
• Journal: Familial Cancer
• Published: 2026;25(3)
• Read it: PubMed · Publisher · Free full text

Abstract

Pleural mesothelioma (PM) is a malignancy with a relevant genetic component, with germline mutations identified in up to 12% of cases. International guidelines recommend universal germline testing; however, its implementation in routine clinical practice remains inconsistent. This nationwide survey aimed to assess current clinical practice, attitudes, and barriers related to genetic testing among Italian specialists within the Mesothelioma Team Italy (MET-I) network. A 24-item questionnaire was distributed to MET-I members in 2025, exploring access to testing, clinical use, and perceived obstacles to both germline and somatic DNA sequencing. Forty-five physicians responded (53.6%). Although access to germline testing was relatively high (77.8%), only 6.7% of respondents routinely recommended it. Conversely, somatic NGS was widely available (95.6%) and primarily used for clinical trial screening (66.7%). The main barriers to germline testing included costs (62.2%), limited access to genetic counseling (51.1%), and insufficient physician awareness (48.8%). Despite the availability of genetic testing technologies, germline genetic testing in PM is underutilized in Italy.

© 2026. The Author(s).

In plain English

This brief report described a survey of physicians in the Mesothelioma Team Italy (MET-I) network about genetic testing in pleural mesothelioma. A 24-item multiple-choice questionnaire was emailed to all 84 MET-I members in March 2025, and 45 (53.6%) responded. Most respondents were medical oncologists, and most worked at academic centers in Northern Italy. For germline testing (testing for inherited gene changes), 77.8% of respondents had access, but only 3 (6.7%) prescribed it routinely. Another 35.6% prescribed it occasionally, and 57.8% never routinely did. Somatic testing of tumor DNA was more widely available: only 4.4% of respondents lacked access. The reason most often cited for prescribing it was an available clinical trial with molecular screening criteria (66.7% of respondents). The barriers named most often were cost (62.2%), limited access to genetic counseling (51.1%), lack of physician awareness (48.8%) and lack of guidelines (31.1%). The authors concluded there was a gap between the availability of germline testing and its actual use. They noted the small sample, the predominance of respondents from Northern Italy and academic centers, and the purely descriptive design.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional questionnaire survey of physicians (brief report), analyzed descriptively
• Who was studied: Members of the Mesothelioma Team Italy (MET-I) network. 84 members were surveyed and 45 (53.6%) responded. The survey was emailed on March 4, 2025, with a deadline of July 31, 2025. Respondents were 60% female, 66.7% medical oncologists, 88.9% working in Northern Italy and 84.4% at academic centers.
• Exposure: Not a study of asbestos exposure. The survey asked about physicians' access to, use of, and barriers to germline and somatic DNA testing in pleural mesothelioma. No patient data were collected.
• Main results:
  • Among the 45 respondents, 77.8% had access to germline testing, but only 6.7% prescribed it routinely.
  • For germline testing, 57.8% of respondents never routinely prescribed it, 35.6% did so occasionally, and 3 respondents (6.7%) did so routinely.
  • Only 22.2% of respondents had formal training in genetic counseling.
  • The reasons for germline testing cited most often were a family history of mesothelioma and known familial pathogenic variants, each cited by 82.2% of respondents.
  • Only 4.4% of respondents lacked access to somatic NGS (tumor DNA sequencing).
  • For somatic testing, 55.6% of respondents did not routinely recommend it, 35.5% did so occasionally, and 8.8% did so routinely.
  • The reason respondents cited most often for prescribing somatic testing was the availability of a clinical trial with molecular screening criteria (66.7% of respondents).
  • The most frequently reported barriers were cost (62.2% of respondents) and limited access to genetic counseling (51.1%).
  • Other reported barriers were lack of physician awareness (48.8%) and lack of guidelines (31.1%).
  • 86.7% of respondents expressed interest in further education.
• The authors' conclusion: The authors concluded that, within this Italian expert network, there was a gap between the availability of germline testing and its actual use in clinical practice.
• Limitations the authors state:
  • Respondents were mostly from Northern Italy and academic centers.
  • The sample size was relatively small.
  • The survey design gives only a descriptive overview.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Germline Mutation, Mesothelioma, Clinical Trial, Genetic Counseling.

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