Huma Q Rana1, Lindsay Kipnis2, Kristin Hehir3, Angel Cronin4, Tim Jaung4, Samantha M Stokes3, Fatemeh Fekrmandi4, Donna Vatnick3, Ursula A Matulonis5, Judy E Garber6, Alexi A Wright7. 1. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA; Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA, USA. Electronic address: HumaQ_Rana@dfci.harvard.edu. 2. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA, USA. 3. Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA; Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA, USA. 4. Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA. 5. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. 6. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA; Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA, USA. 7. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA.
Abstract
OBJECTIVE: Germline genetic testing is crucial to the care of ovarian cancer patients, and as part of the guideline-based care for ovarian cancer patient's adherence to this recommendation has been low. We sought to determine whether embedding a genetic counselor (GC) within a medical and gynecologic oncology clinic would increase testing rates and improve the timeliness of testing. METHODS: Prospective cohort study of 358 ovarian cancer patients seen by medical and gynecologic oncologists between 2013 and 2015. Rates of referrals, completion of counseling, and genetic testing and timeliness of counseling were abstracted before and after a GC was embedded in the clinic in 2014. An additional year of data (2015) was collected to evaluate sustainability of the intervention. RESULTS: Between 2013 and 2015, 88-92% of women were referred for genetic testing, but in 2013 only 66% completed counseling and 61% were tested. After a GC was embedded in the clinic in 2014, more than 80% of referred women completed counseling and germline genetic testing. Time to genetic counseling also decreased from a median of 107 to 40 days, irrespective of age and cancer family history (p < 0.01). CONCLUSIONS: Embedding a GC into the workflow for ovarian cancer patients is an effective way of improving access to genetic counseling, testing rates, and the timeliness of testing.
OBJECTIVE: Germline genetic testing is crucial to the care of ovarian cancerpatients, and as part of the guideline-based care for ovarian cancerpatient's adherence to this recommendation has been low. We sought to determine whether embedding a genetic counselor (GC) within a medical and gynecologic oncology clinic would increase testing rates and improve the timeliness of testing. METHODS: Prospective cohort study of 358 ovarian cancerpatients seen by medical and gynecologic oncologists between 2013 and 2015. Rates of referrals, completion of counseling, and genetic testing and timeliness of counseling were abstracted before and after a GC was embedded in the clinic in 2014. An additional year of data (2015) was collected to evaluate sustainability of the intervention. RESULTS: Between 2013 and 2015, 88-92% of women were referred for genetic testing, but in 2013 only 66% completed counseling and 61% were tested. After a GC was embedded in the clinic in 2014, more than 80% of referred women completed counseling and germline genetic testing. Time to genetic counseling also decreased from a median of 107 to 40 days, irrespective of age and cancer family history (p < 0.01). CONCLUSIONS: Embedding a GC into the workflow for ovarian cancerpatients is an effective way of improving access to genetic counseling, testing rates, and the timeliness of testing.
Authors: Karin Kast; Julia Häfner; Evelin Schröck; Arne Jahn; Carmen Werner; Cornelia Meisel; Pauline Wimberger Journal: Breast Care (Basel) Date: 2021-06-17 Impact factor: 2.268
Authors: Kyra Bokkers; Ronald P Zweemer; Marco J Koudijs; Sanne Stehouwer; Mary E Velthuizen; Eveline M A Bleiker; Margreet G E M Ausems Journal: Fam Cancer Date: 2021-10-07 Impact factor: 2.446