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Simple Summary: Genetic testing is increasingly used in children with cancer to detect inherited genetic changes that may increase their risk for cancer. Many families are interested in this testing, but little is known about how it affects the entire family. This study explores how parents experience the impact of genetic testing for cancer risk on their family as a whole. We interviewed both parents in six families with a child diagnosed with cancer to understand their perspectives. The testing was performed by analyzing genes linked to cancer risk. Parents found genetic testing valuable and relatively straightforward but noted that it was hard to separate its effects from the emotional stress of their child's cancer diagnosis and treatment. Despite this, they described how the testing influenced family life in significant ways. Key themes included how families talk about genetic testing, the importance of spending time together, differences in coping between parents, feelings of guilt and forgiveness, and worries about the future health of the family. This research highlights that genetic testing impacts families deeply and that healthcare providers should address these family-level challenges to better support families during an already difficult time. Objectives: Germline genetic testing is increasingly being integrated into pediatric oncology and a large number of families are interested. Current research on the psychological impact of germline genetic testing is limited by a main focus on individual outcomes in parents or children and little is known about its impact at the family level. Our study addresses that limitation by exploring parents' lived experiences of how their family—as a whole—is affected by germline genetic testing for cancer predisposition. Methods: In six families who opted for germline genetic testing in the context of cancer predisposition, both parents of six ill children (five boys) with an average age of 9.67 years (SD = 3.77 years) were interviewed individually (N = 12). Germline genetic testing was performed by exome sequencing followed by analysis of a panel of childhood cancer predisposition genes in pediatric cancer patients and their parents. Their experiences were elicited through semi-structured interviews and the data were analyzed using Multi Family Member Interview Analysis. This qualitative study was conducted at Ghent University Hospital in Belgium. Results: The findings demonstrated that while germline genetic testing was generally viewed as a valuable and straightforward step in the child's oncology trajectory, parents found it difficult to distinguish its impact from the overwhelming stressors of their child's cancer diagnosis and treatment. However, parents recognized that the testing also significantly affected various family-level processes. Five main themes were identified: talking about germline genetic testing, being together matters (more), differences in coping with germline genetic testing between partners, feelings of guilt and mutual forgiveness, and concerns about the future health of the family. Conclusions: Given the expanded use of germline genetic testing in pediatric oncology, it is critical for clinicians to address the family-level impacts of germline genetic testing. Although families are affected by these issues, they often do not raise them due to the overwhelming challenges posed by the cancer diagnosis and treatment. Proactively addressing these themes could improve the support provided to families undergoing germline genetic testing for cancer predisposition. [ABSTRACT FROM AUTHOR]

Objective: Cancer predisposition syndromes are being more frequently recognized in the etiology of pediatric oncology and genetic‐related technologies are evolving rapidly, leading to an increasing availability of genetic testing for families. This systematic review assessed the psychological impact of genetic testing on children and parents in the context of childhood cancer. Methods: Searches were performed using three databases (Web of Science, Pubmed and Embase) to identify relevant empirical studies. Following Cochrane guidelines, we screened 3838 articles and identified 18 eligible studies, representing the perspectives of children and/or parents. Results: The included studies described the impact of genetic testing in different contexts (e.g. predictive testing and diagnostic testing) and in different subgroups, (e.g. carriers and non‐carriers). Overall, the studies did not identify clinically‐relevant long‐term increases in negative emotions (depression, anxiety, distress, uncertainty, guilt) as a result of genetic testing. Negative emotions were typically time‐limited and generally occurred in families with particular characteristics (e.g. those with a history of multiple cancer diagnoses, families receiving an unfavorable result for one child and a favorable result in siblings, and those with pre‐existing mental health difficulties). Positive emotions (hopefulness, relief and peace of mind) were also reported. Knowing their genetic risk status appeared to help to foster empowerment among families, regardless of the result and any associated emotions. Conclusions: Genetic testing in pediatric oncology does not appear to cause significant additional harm and can lead to positive outcomes. Clinicians need to be especially attentive when counseling families at increased risk of distress. [ABSTRACT FROM AUTHOR]