Objectives Mismatch repair gene testing for patients with endometrial cancer assists in identifying suspected mutation carriers with Lynch syndrome. The purpose of this study is to examine the factors predictive of endometrial cancer patients’ adherence to genetic counseling referrals for genetic testing.

Methods An IRB-approved retrospective study was conducted on eligible patients identified at multidisciplinary tumor boards between January 2016 to October 2019. Our primary outcome was genetic testing completion when recommended by a genetic counselor. Data collected included age at diagnosis, ethnicity, stage, metastasis, mismatched repair deficiency testing, presence of Lynch syndrome, and genetic counselor presence at the tumor board. We performed univariate analyses to test for group differences using the independent student’s t-test for age and Fisher’s exact test for categorical variables. We performed multivariable logistic regression to determine the independent odds of genetic testing, including age, metastasis, and stage.

Results Our sample included 165 patients, and genetic testing was recommended for 30 (18.2%). Sixteen of the 30 (53.3%) patients recommended for testing adhered to the recommendation. As a result, three patients were diagnosed with Lynch syndrome. There was a significant difference in age between those tested versus those who did not get tested. On multivariable analysis, for every one year increase in age, the odds of genetic testing decreased. There was a trend toward reduced odds of genetic testing among patients with stage III/IV compared to I/II cancer.

Conclusions Our findings suggest an opportunity to increase the genetic testing referral process for older patients and possibly those with more advanced disease.