Hereditary Cancer Risk Assessment and Genetic Testing in the Community-Practice Setting
| Autor: | Lindsey Alico, Mark S DeFrancesco, Richard Waldman, Ryan Bernhisel, Royce T. Adkins, Jennifer Logan, Dana Karanik, Melissa M Pearlstone |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Referral Attitude of Health Personnel Genetic counseling Genes BRCA2 Genes BRCA1 Genetic Counseling Risk Assessment Workflow 03 medical and health sciences 0302 clinical medicine Patient satisfaction Obstetrics and gynaecology Patient Education as Topic Neoplasms Health care medicine Humans 030212 general & internal medicine Genetic Testing Prospective Studies Prospective cohort study Genetic testing medicine.diagnostic_test business.industry Process Assessment Health Care Obstetrics and Gynecology DNA-Binding Proteins Obstetrics Checkpoint Kinase 2 Gynecology Patient Satisfaction 030220 oncology & carcinogenesis Family medicine Feasibility Studies Female business Risk assessment Fanconi Anemia Complementation Group N Protein |
| Zdroj: | Obstetrics and gynecology. 132(5) |
| ISSN: | 1873-233X |
| Popis: | Objective To evaluate the feasibility and results of incorporating routine hereditary cancer risk assessment, counseling, and follow-up genetic testing in the community obstetrics and gynecology practice setting without referral to a genetic counselor. Methods This prospective process intervention study was conducted with two obstetrics and gynecology practice groups (five sites). The intervention included baseline process assessment, refinement of clinic-specific patient screening workflows and tools, and training in hereditary cancer risk screening and follow-up. Outcomes related to hereditary cancer assessment and testing were measured during an 8-week postintervention period. Patients and health care providers were surveyed about satisfaction with the process. Data also were collected during the 8 weeks before the intervention to assess the effects of screening process improvements. Results A total of 4,107 patients were seen during the postintervention period, and 92.8% (3,811) were assessed for hereditary cancer risk. Among those assessed, 906 of 3,811 (23.8%) women met National Comprehensive Cancer Network guidelines for genetic testing, and 813 of 906 (89.7%) eligible patients were offered genetic testing. A total of 165 of 4,107 (4.0%) women completed genetic testing and received a final test result. This represents a fourfold increase over genetic testing immediately before the intervention (1.1%) and an eightfold increase over the previous year (0.5%). Testing identified pathogenic variants in 9 of 165 (5.5%) tested women. All health care providers (15/15) reported that they will continue to use the established hereditary cancer risk assessment process. In addition, 98.8% (167/169) of patients who submitted a sample for genetic testing and completed a patient satisfaction survey stated that they were able to understand the information provided, and 97.6% (165/169) expressed satisfaction with the overall process. Conclusion It is feasible to incorporate hereditary cancer risk assessment, education, and testing into community obstetrics and gynecology practices. As a result, multigene panel testing identified significant cancer risks that otherwise would not have been recognized. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|