Jeanna M McCuaig1, Melanie Care2, Sarah E Ferguson3, Raymond H Kim4, Tracy L Stockley5, Kelly A Metcalfe6. 1. Familial Cancer Clinic, University Health Network, 610 University Avenue, Toronto, ON M5G 2M9, Canada; Lawrence S Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada. Electronic address: Jeanna.mccuaig@uhn.ca. 2. Department of Molecular Genetics, University of Toronto, 27 King's College Circle, Toronto5, ON M5S 1A8, Canada; Division of Clinical Laboratory Medicine, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada. 3. Division of Gynecologic Oncology, University Health Network, 610 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Obstetrics and Gynecology, University of Toronto, 27 King's College Circle, Toronto, ON M5S 1A8, Canada. 4. Familial Cancer Clinic, University Health Network, 610 University Avenue, Toronto, ON M5G 2M9, Canada; Division of Medical Oncology, University Health Network, 610 University Avenue, Toronto, ON M5G 2M9, Canada; Department of Medicine, University of Toronto, 27 King's College Circle, Toronto, ON M5S 1A8, Canada. 5. Division of Clinical Laboratory Medicine, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, 27 King's College Circle, Toronto, ON M5S 1A8, Canada. 6. Lawrence S Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada; Women's College Research Institute, 72 Grenville Street, Toronto, ON M5S 1B2, Canada.
Abstract
OBJECTIVE: This study compares the rate and time to genetic referral, and patient uptake of germline genetic services, before and after implementation of reflex BRCA1/2 tumor testing for high-grade serous ovarian cancer (HGSOC) in a universal healthcare system. METHODS: A retrospective chart review of HSGOC patients diagnosed in the year before (PRE) and after (POST) implementation of reflex BRCA1/2 tumor testing was conducted. Clinical information (date/age at diagnosis, personal/family history of breast/ovarian cancer, cancer stage, primary treatment, tumor results) and dates of genetics referral, counseling, and germline testing were obtained. Incident rate ratios (IRR) and 95% CI were calculated using negative binomial regression. Time to referral was evaluated using Kaplan-Meier survival analysis. Fisher Exact tests were used to evaluate uptake of genetic services. RESULTS: 175 HGSOC patients were identified (81 PRE; 94 POST). Post-implementation of tumor testing, there was a higher rate of genetics referral (12.88 versus 7.10/1000 person-days; IRR = 1.60, 95% CI: 1.07-2.42) and a shorter median time from diagnosis to referral (59 days PRE, 33 days POST; p = .04). In the POST cohort, most patients were referred prior to receiving their tumor results (n = 63/77; 81.8%). Once referred, most patients attended genetic counseling (94.5% PRE, 97.6% POST; p = .418) and pursue germline testing (98.6% PRE; 100% POST; p = .455). CONCLUSIONS: Following implementation of reflex BRCA1/2 tumor testing for HGSOC, significant improvements to the rate and time to genetics referral were identified. Additional studies are needed to evaluate physician referral practices and the long-term impact of reflex tumor testing.
OBJECTIVE: This study compares the rate and time to genetic referral, and patient uptake of germline genetic services, before and after implementation of reflex BRCA1/2tumor testing for high-grade serous ovarian cancer (HGSOC) in a universal healthcare system. METHODS: A retrospective chart review of HSGOC patients diagnosed in the year before (PRE) and after (POST) implementation of reflex BRCA1/2tumor testing was conducted. Clinical information (date/age at diagnosis, personal/family history of breast/ovarian cancer, cancer stage, primary treatment, tumor results) and dates of genetics referral, counseling, and germline testing were obtained. Incident rate ratios (IRR) and 95% CI were calculated using negative binomial regression. Time to referral was evaluated using Kaplan-Meier survival analysis. Fisher Exact tests were used to evaluate uptake of genetic services. RESULTS: 175 HGSOC patients were identified (81 PRE; 94 POST). Post-implementation of tumor testing, there was a higher rate of genetics referral (12.88 versus 7.10/1000 person-days; IRR = 1.60, 95% CI: 1.07-2.42) and a shorter median time from diagnosis to referral (59 days PRE, 33 days POST; p = .04). In the POST cohort, most patients were referred prior to receiving their tumor results (n = 63/77; 81.8%). Once referred, most patients attended genetic counseling (94.5% PRE, 97.6% POST; p = .418) and pursue germline testing (98.6% PRE; 100% POST; p = .455). CONCLUSIONS: Following implementation of reflex BRCA1/2tumor testing for HGSOC, significant improvements to the rate and time to genetics referral were identified. Additional studies are needed to evaluate physician referral practices and the long-term impact of reflex tumor testing.
Authors: Margreet G E M Ausems; Joanne A de Hullu; Vera M Witjes; Jozé C C Braspenning; Nicoline Hoogerbrugge; Yvonne H C M Smolders; Dorien M A Hermkens; Marian J E Mourits; Marjolijn J L Ligtenberg Journal: Fam Cancer Date: 2022-05-16 Impact factor: 2.375
Authors: Stacy W Gray; Rebecca A Ottesen; Madeline Currey; Mihaela Cristea; Janet Nikowitz; Susan Shehayeb; Vanessa Lozano; Julie Hom; Julie Kilburn; Lisa N Lopez; Sam Wing; Ernesto Sosa; Jenny Shen; Michael Morris; Bedros Dilsizian; Thomas Joseph; James Shen; Camille Adeimy; Tanyanika Phillips; Bahareh Bahadini; Joyce C Niland Journal: JCO Clin Cancer Inform Date: 2022-09
Authors: A Russo; L Incorvaia; E Capoluongo; P Tagliaferri; S Gori; L Cortesi; M Genuardi; D Turchetti; U De Giorgi; M Di Maio; M Barberis; M Dessena; M Del Re; A Lapini; C Luchini; B A Jereczek-Fossa; A Sapino; S Cinieri Journal: ESMO Open Date: 2022-05-19
Authors: Jenny Lin; Ravi N Sharaf; Rachel Saganty; Danyal Ahsan; Julia Feit; Andrea Khoury; Hannah Bergeron; Eloise Chapman-Davis; Evelyn Cantillo; Kevin Holcomb; Stephanie V Blank; Ying Liu; Charlene Thomas; Paul J Christos; Drew N Wright; Steven Lipkin; Kenneth Offit; Melissa K Frey Journal: Gynecol Oncol Date: 2021-05-19 Impact factor: 5.304
Authors: Emily A Goebel; Jennifer Kerkhof; Oleksandra Dzyubak; C Meg McLachlin; Jacob McGee; Bekim Sadikovic Journal: Genes (Basel) Date: 2022-08-06 Impact factor: 4.141