Longitudinal adherence to breast cancer surveillance following cancer genetic testing in an integrated health care system.

Autor: Knerr S; Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, 98195, USA. saknerr@uw.edu., Guo B; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA., Wernli KJ; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA., Mittendorf KF; Department of Translational and Applied Genomics (TAG), Kaiser Permanente Center for Health Research, Portland, OR, USA.; Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA., Feigelson HS; Institute for Health Research, Kaiser Permanente, Denver, CO, USA., Gilmore MJ; Department of Translational and Applied Genomics (TAG), Kaiser Permanente Center for Health Research, Portland, OR, USA., Jarvik GP; Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA., Kauffman TL; Kaiser Permanente Center for Health Research, Portland, OR, USA., Keast E; Kaiser Permanente Center for Health Research, Portland, OR, USA., Liles EG; Kaiser Permanente Center for Health Research, Portland, OR, USA., Lynch FL; Kaiser Permanente Center for Health Research, Portland, OR, USA., Muessig KR; Department of Translational and Applied Genomics (TAG), Kaiser Permanente Center for Health Research, Portland, OR, USA., Okuyama S; Denver Health and Hospital Authority, Denver, CO, USA., Veenstra DL; Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA, USA., Zepp JM; Department of Translational and Applied Genomics (TAG), Kaiser Permanente Center for Health Research, Portland, OR, USA., Wilfond BS; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA., Devine B; Department of Health Systems and Population Health, School of Public Health, University of Washington, Box 351621, Seattle, WA, 98195, USA.; Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA, USA., Goddard KAB; Department of Translational and Applied Genomics (TAG), Kaiser Permanente Center for Health Research, Portland, OR, USA.; Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
Jazyk: angličtina
Zdroj: Breast cancer research and treatment [Breast Cancer Res Treat] 2023 Oct; Vol. 201 (3), pp. 461-470. Date of Electronic Publication: 2023 Jul 20.
DOI: 10.1007/s10549-023-07007-w
Abstrakt: Purpose: Screening with mammography and breast magnetic resonance imaging (MRI) is an important risk management strategy for individuals with inherited pathogenic variants (PVs) in genes associated with increased breast cancer risk. We describe longitudinal screening adherence in individuals who underwent cancer genetic testing as part of usual care in a vertically integrated health system.
Methods: We determined the proportion time covered (PTC) by annual mammography and breast MRI for individuals with PVs in TP53, BRCA1, BRCA2, PALB2, NF1, CHEK2, and ATM. We determined time covered by biennial mammography beginning at age 50 years for individuals who received negative results, uncertain results, or with PVs in genes without specific breast cancer screening recommendations.
Results: One hundred and forty individuals had PVs in TP53, BRCA1, BRCA2, PALB2, NF1, CHEK2, or ATM. Among these individuals, average PTC was 48% (range 0-99%) for annual screening mammography and 34% (range 0-100%) for annual breast MRI. Average PTC was highest for individuals with PVs in CHEK2 (N = 14) and lowest for individuals with PVs in TP53 (N = 3). Average PTC for biennial mammography (N = 1,027) was 49% (0-100%).
Conclusion: Longitudinal screening adherence in individuals with PVs in breast cancer associated genes, as measured by the proportion of time covered, is low; adherence to annual breast MRI falls below that of annual mammography. Additional research should examine screening behavior in individuals with PVs in breast cancer associated genes with a goal of developing interventions to improve adherence to recommended risk management.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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