遗传咨询（GC）是遗传癌症风险评估（GCRA）中的标准护理。对已发表研究所报道的数据进行严格评估是确保GC的循证实施的关键。我们遵循PRISMA指南和GRADE方法，对与GCRA中的预测和后测GC相关的17个患者报告和卫生服务结果进行了系统综述和荟萃分析。在5393篇筛选文章中，有25篇符合纳入标准。没有符合纳入标准的后测GC结果的文章。对于患者报告的结果，前测GC显著降低了担忧程度，增加了知识水平，降低了感知风险，但对患者焦虑、抑郁、决策冲突、满意度或进行基因测试的意愿等方面并没有明显影响。对于卫生服务结果，前测GC增加了正确的基因检测订单，减少了不适宜的服务，增加了配偶对基因检测的支持，加快了护理交付进程，但并不一致地改善了癌症预防行为，也没有准确的风险评估。所提供的证据的GRADE确定度非常低或低。未包含的研究没有阐明GC对死亡率、级联测试、费用效益、护理协调、共享决策或患者时间负担的影响。由于质量不高或证据缺失，GC对相关结果的真实影响尚不清楚。虽然荟萃分析发现前测GC对知识、担忧和风险感知有益的影响，但根据GRADE方法学，这些证据的确定度较低。需要进一步研究以支持GC在GCRA中的循证应用。版权所有©2023。Elsevier Inc.出版。

Genetic counseling (GC) is standard of care in genetic cancer risk assessment (GCRA). A rigorous assessment of the data reported from published studies is crucial to ensure the evidence-based implementation of GC.We conducted a systematic review and meta-analysis of 17 patient-reported and health services-related outcomes associated with pre- and post-test GC in GCRA in accordance with PRISMA guidelines and GRADE methodology.25 of 5393 screened articles met inclusion criteria. No articles reporting post-test GC outcomes met inclusion criteria. For patient-reported outcomes, pre-test GC significantly decreased worry, increased knowledge, and decreased perceived risk, but did not significantly affect patient anxiety, depression, decisional conflict, satisfaction, or intent to pursue genetic testing. For health-services outcomes, pre-test GC increased correct genetic test ordering, reduced inappropriate services, increased spousal support for genetic testing, and expedited care delivery, but did not consistently improve cancer prevention behaviors nor lead to accurate risk assessment. The GRADE certainty in the evidence was very low or low. No included studies elucidated GC effect on mortality, cascade testing, cost-effectiveness, care-coordination, shared decision-making, or patient time burden.The true impact of GC on relevant outcomes is not known due to low quality or absent evidence. While a meta-analysis found that pre-test GC had beneficial effects on knowledge, worry and risk perception, the certainty of this evidence was low according to GRADE methodology. Further studies are needed to support the evidence-based application of GC in GCRA.Copyright © 2023. Published by Elsevier Inc.