Community-Based Genetic Screening Reaches Rural and Vulnerable Populations

Many adults inherit genetic changes that increase their risk for cancer and cardiovascular disease, yet access to testing often remains concentrated in large medical centers. Reaching rural and socially vulnerable communities can be difficult, even when tests are simple and prevention strategies exist. Extending screening beyond specialty clinics could support earlier detection with appropriate counseling and follow-up. A new study shows that a statewide, community-embedded genomic screening program can reach residents across a large area through flexible, no-cost testing options.

At the Medical University of South Carolina (MUSC), the In Our DNA SC program offers voluntary, no-cost population-wide genetic screening to identify inherited risks for hereditary breast and ovarian cancer syndrome, Lynch syndrome, and familial hypercholesterolemia. The program enables participation through MUSC clinics, community collection events, and at-home kits, using either a blood sample or a cheek swab. Deidentified participant data are added to a secure database to support development of more personalized prevention and treatment approaches.

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Published in JAMA Network Open on July 13, 2026, the study evaluated the program’s geographic and social reach. More than 50,000 adults completed screening, with participation from all 46 South Carolina counties, including many rural and socially vulnerable communities. After adjusting for population size, participation remained strong across both urban and rural areas, and analyses incorporated measures of rurality and the Centers for Disease Control and Prevention’s Social Vulnerability Index.

Approximately one in every 65 participants screened carried a variant associated with one of the three targeted conditions. These individuals were offered no‑cost genetic counseling to interpret findings for themselves and their families and to receive recommendations for appropriate follow‑up care. The findings indicate that flexible testing options, community partnerships, and implementation science can enable population-wide genomic screening in communities that have historically faced barriers to this type of care.

Investigators noted that the program’s statewide reach aims to improve representation of South Carolinians in genomic research at a time when such screening remains relatively uncommon in the U.S. They added that the next phase will examine whether broad reach leads to improved preventive care and better health over time. The initiative is designed to help prevent disease before it starts or enable earlier detection through genetic counseling, screening, and preventive care.

“Genomic screening gives us the opportunity to identify people with inherited risk before they become sick. If we can find those individuals early, we can connect them with genetic counseling, screening and preventive care that should ultimately save lives,” said Daniel Judge, M.D., principal investigator of In Our DNA SC and director of the MUSC Cardiovascular Genetics Program.

“The big message is that we've done a great job reaching every county regardless of rurality or vulnerability. But there's still room for us to improve our reach in some of the most rural counties,” stated Kalyani Sonawane, Ph.D., assistant director of data science and analytics at MUSC Hollings Cancer Center.

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MUSC Hollings Cancer Center