What is a VUS or variant of uncertain clinical significance?

When a variant’s contribution to disease is uncertain and cannot be identified as either benign or pathogenic, the genetic variant is reported as a VUS. When this occurs, Quest Diagnostics performs an in-depth investigation to evaluate the likelihood that the VUS causes disease. The details of this investigation are included in your clinical result report.

What is the Family Insight Program?

We use numerous methods and techniques to gather information about VUS. One of these tools is the Family Insight Program, which allows for segregation analysis, or determining whether the VUS is tracking with the disease in the family. By gathering clinical and family history information on your patient, we are able to identify appropriate family members to offer testing for the VUS identified in your patient. We offer this program with the hope of further elucidating the significance of the variant(s).

It is important to note, participation in the Family Insight Program does not guarantee VUS reclassification. Participation of family members in the Family Insight Program should also not replace genetic counseling and/or clinically indicated genetic testing.

Additionally, incidental findings identified through this program will not be evaluated. Identity testing may be performed as a quality measure. There is no additional charge to family members tested under this program. However, individuals will not receive a report, nor will they learn their genetic testing results. At the completion of the program, your patient’s report may be updated to incorporate any additional information we were able to glean about the variant interpretation for your patient.

What happens if a VUS is reclassified?

If the VUS is reclassified as part of the Family Insight Program, we will contact you.

What happens if a VUS is not reclassified?

If the VUS is not reclassified as a result of the family testing, it is possible new information (external and internal) will become available in the future that may cause the VUS classification to change. Since we cannot predict if or when this reclassification will occur, it is important for your patient to remain in contact with your office to ensure they can also be notified of any change in the interpretation of the VUS.

What are the exclusions to this program?

We will not offer testing to family members if:

  1. The variant has been classified as benign, likely benign, likely pathogenic, or pathogenic or if the patient has an otherwise positive report.
  2. The VUS is associated with a specific inheritance pattern and further family genetic information will not clarify the significance of the VUS.
  3. Phenotype of the patient is inconsistent with the reported phenotype of the gene(s) involved.

What is the next step?

If your patient is interested in participating in our Family Insight Program, please access the Family Insight Program Application and Consent forms in the Resources section.

Upon receipt of completed information, we will notify you about whether or not your patient has been approved for the Family Insight Program.

What if my patient has a VUS and I want to get a variant update?

If you want an update on the classification of a variant, please fill out a Variant Update Request here.

A reminder

Medical management recommendations and reproductive decisions should not be based on the presence or absence of a VUS. Instead, recommendations should be made based on your patient’s personal and/or family history. In some cases, additional genetic testing may be warranted.

If you have any questions about the Family Insight Program, please contact us at 1.866.GENE.INFO (1.866.436.3463) and ask to speak to a Genetic Counselor.

Call 1.866.GENE.INFO (1.866.436.3463)

for clinical consultation on test selection and results interpretation

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