Disparities in genetics assessment for women with ovarian cancer: Can we do better?
| Autor: | Lee-may Chen, Julie Mak, Amie Blanco, Erica Manrriquez, Jocelyn S. Chapman |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Referral
Genetic counseling Black People Gynecologic oncology White People 03 medical and health sciences 0302 clinical medicine Asian People Humans Medicine Genetic Testing 030212 general & internal medicine Healthcare Disparities Family history Referral and Consultation Socioeconomic status Retrospective Studies Genetic testing Ovarian Neoplasms Genetics medicine.diagnostic_test business.industry Obstetrics and Gynecology Retrospective cohort study Hispanic or Latino Middle Aged medicine.disease United States Oncology 030220 oncology & carcinogenesis Female business Ovarian cancer SEER Program |
| Zdroj: | Gynecologic Oncology. 149:84-88 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2017.10.034 |
| Popis: | We sought to characterize referral patterns for genetic counseling for women with ovarian cancer and hypothesized that differences in referral and testing rates are shaped by socioeconomic factors.Patients were identified by pathology reports from August 2012 to January 2016 containing the words "serous" or "ovarian." Patient information was obtained via electronic medical record. Primary outcomes were placement of a genetics referral and completion of counseling. A secondary outcome was completion of genetic testing.We identified 246 women with a diagnosis of ovarian cancer. Ten were previously counseled and excluded. 53% of patients were referred for counseling with mean time from diagnosis to counseling of 4.6months. Age and family history were not associated with referral, however rates differed by race with 61% of Caucasian and 40%, 38% and 33% of Asian, Latina and Black women, respectively, referred (p=0.035). Overall, 36% of patients diagnosed underwent counseling, and 33% were tested. English language (p0.0001), high-grade serous histology (p=0.0001) and private or Medicare insurance (p0.0001) were significantly associated with referral.We have not yet reached the Society of Gynecologic Oncology recommendation for referral to genetics. Women of color and those with public insurance have lower referral rates. This disparity in care impacts cancer treatment options and prevents appropriate screening for other hereditary malignancies. To provide comprehensive oncology care, including genetic assessment, we recommend focusing on these barriers including improving outreach and interpreter services. |
| Databáze: | OpenAIRE |
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