Jeanna M McCuaig1, Alicia A Tone2, Manjula Maganti3, Tina Romagnuolo2, Nicole Ricker2, Jennifer Shuldiner4, Gary Rodin5, Tracy Stockley6, Raymond H Kim7, Marcus Q Bernardini8. 1. Familial Breast & Ovarian Cancer Clinic, Princess Margaret Cancer Centre, The University Health Network, Toronto, ON, Canada; Molecular Genetics, University of Toronto, Toronto, ON, Canada. 2. Gynecologic Oncology, Princess Margaret Cancer Centre, The University Health Network, Toronto, ON, Canada. 3. Biostatistics, Princess Margaret Cancer Centre, The University Health Network, Toronto, ON, Canada. 4. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 5. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Supportive Care, Princess Margaret Cancer Centre, The University Health Network, Toronto, ON, Canada. 6. Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, The University Health Network, Toronto, ON, Canada; Clinical Laboratory Genetics, Princess Margaret Cancer Centre, The University Health Network, Toronto, ON, Canada. 7. Familial Breast & Ovarian Cancer Clinic, Princess Margaret Cancer Centre, The University Health Network, Toronto, ON, Canada. 8. Gynecologic Oncology, Princess Margaret Cancer Centre, The University Health Network, Toronto, ON, Canada. Electronic address: Marcus.Bernardini@uhn.ca.
Abstract
OBJECTIVE: Genetic testing identifies cancer patients who may benefit from targeted treatment and allows for enhanced cancer screening and risk-reduction in their at-risk relatives. Traditional models of genetic counseling (GC) cannot meet the increasing demand and urgency for genetic testing. The objective of this study was to evaluate a new model of service delivery to improve the efficiency of pre-test GC for panel-based genetic testing. METHODS: A parallel, two-armed, randomized non-inferiority study compared traditional and modified pre-test GC models (1:2) prior to panel-based genetic testing. Participants were adult females, whose first-degree relative died of serous ovarian cancer. In the modified group, participants were emailed a 20-minute presentation prior to a scheduled pre-test GC telephone call. Psychosocial and knowledge questionnaires were provided at baseline (P1) and one week after pre-test GC (P2). RESULTS:382 women completed pre-test GC (256 modified, 126 traditional). There were no differences in marital status, education level or household income. Pre-test GC time was shorter in the modified group (average 19 vs. 46 min, p < 0.001), with no difference in post-test GC time (average 16 min each, p = 0.78). The modified pre-test GC model was found to be non-inferior to traditional GC on measures of cancer-specific distress, depression, anxiety, decisional conflict, ovarian cancer knowledge and satisfaction. Perceived lifetime risk for ovarian cancer decreased to a lesser extent from baseline in women who received modified pre-test GC. CONCLUSIONS: A 20-minute presentation prior to pre-test telephone GC is non-inferior to traditional in-person GC on all variables tested, except for perceived ovarian cancer risk. This modified model improved GC efficiency without negatively affecting psychosocial outcomes, providing an alternative strategy to meet the growing demand for genetic testing.
RCT Entities:
OBJECTIVE: Genetic testing identifies cancerpatients who may benefit from targeted treatment and allows for enhanced cancer screening and risk-reduction in their at-risk relatives. Traditional models of genetic counseling (GC) cannot meet the increasing demand and urgency for genetic testing. The objective of this study was to evaluate a new model of service delivery to improve the efficiency of pre-test GC for panel-based genetic testing. METHODS: A parallel, two-armed, randomized non-inferiority study compared traditional and modified pre-test GC models (1:2) prior to panel-based genetic testing. Participants were adult females, whose first-degree relative died of serous ovarian cancer. In the modified group, participants were emailed a 20-minute presentation prior to a scheduled pre-test GC telephone call. Psychosocial and knowledge questionnaires were provided at baseline (P1) and one week after pre-test GC (P2). RESULTS: 382 women completed pre-test GC (256 modified, 126 traditional). There were no differences in marital status, education level or household income. Pre-test GC time was shorter in the modified group (average 19 vs. 46 min, p < 0.001), with no difference in post-test GC time (average 16 min each, p = 0.78). The modified pre-test GC model was found to be non-inferior to traditional GC on measures of cancer-specific distress, depression, anxiety, decisional conflict, ovarian cancer knowledge and satisfaction. Perceived lifetime risk for ovarian cancer decreased to a lesser extent from baseline in women who received modified pre-test GC. CONCLUSIONS: A 20-minute presentation prior to pre-test telephone GC is non-inferior to traditional in-person GC on all variables tested, except for perceived ovarian cancer risk. This modified model improved GC efficiency without negatively affecting psychosocial outcomes, providing an alternative strategy to meet the growing demand for genetic testing.
Authors: Nick Dragojlovic; Kennedy Borle; Nicola Kopac; Ursula Ellis; Patricia Birch; Shelin Adam; Jan M Friedman; Amy Nisselle; Alison M Elliott; Larry D Lynd Journal: Genet Med Date: 2020-06-24 Impact factor: 8.822
Authors: Salma Shickh; Daena Hirjikaka; Marc Clausen; Rita Kodida; Chloe Mighton; Emma Reble; Jordan Sam; Seema Panchal; Melyssa Aronson; Tracy Graham; Susan Randall Armel; Emily Glogowski; Christine Elser; Andrea Eisen; June C Carroll; Cheryl Shuman; Emily Seto; Nancy N Baxter; Adena Scheer; Serena Shastri-Estrada; Geoff Feldman; Kevin E Thorpe; Kasmintan A Schrader; Jordan Lerner-Ellis; Raymond H Kim; Hanna Faghfoury; Yvonne Bombard Journal: BMJ Open Date: 2022-04-29 Impact factor: 3.006