How are incidental findings handled in genomic testing and what guidelines govern disclosure?

• A. All incidental findings must be disclosed
• B. Only actionable incidental findings disclosed per consent and ACMG guidelines; counseling and opt-in/out
• C. Incidental findings never disclosed
• D. Actionable incidental findings are disclosed per consent and ACMG guidelines; counseling and opt-in/out

Answer: (D)

Incidental findings are results discovered during genomic testing that are not related to the reason for the test. The best practice is to disclose findings only if they are medically actionable and aligned with the patient’s informed consent, guided by ACMG recommendations. Genetic counseling is essential to help the patient understand the implications, options, and next steps. Because patient values differ, there is an opt-in or opt-out choice for receiving such information, ensuring disclosure respects individual preferences. This approach—disclosing actionable incidental findings per consent and ACMG guidelines with counseling and an opt-in/out option—balances clinical benefit with patient autonomy.