the global landscape of publication and references to BRCA1/ 2 genetic testing guidelines (GTG). Methods This mixed-method study included a systematic literature review; an International Gynecologic Cancer Society (IGCS) informal survey; and cross-reference with Myriad Genetics records, to identify published GTG, their country of origin, and countries referencing them. Results Of 1,011 identified publications, 166 met inclusion criteria, from which 46 unique guidelines were identified, published by 18 countries and 2 regions (Europe and United Kingdom). Authorship from the United States accounted for 63% of publications. Systematic review revealed 34 countries, IGCS survey revealed 22 additional countries, and coordination with Myraid Genetics revealed additional information for 2 countries and primary information 1 country with published and/or referenced guidelines. Of the 57 countries evaluated, 33% published their own guidelines and reference guidelines from another country/region, 5% published their own guidelines, without referencing another country/region, 61% only reference a guideline from another country/region (figure 1). No data was available for 138 of 195 countries, disproportionately from Africa, the Middle East, Eastern Europe, and Southeast Asia. Conclusions Global geographic disparities in the publication and referencing of guidelines exist, with a heavy emphasis on North American and European guidelines in the published literature. These disparities highlight a need for uniform BRCA GTG and testing infrastructure to improve global health equity

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