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Genetics Consultation Rates Following a Diagnosis of High-Grade Serous Ovarian Carcinoma in the Canadian Province of Ontario
  1. Jacob McGee, MD, MPH*,,,
  2. Karen Panabaker, MSc§,
  3. Sean Leonard, BSc,
  4. Peter Ainsworth, MD, PhD,
  5. Laurie Elit, MD and
  6. Salimah Z. Shariff, PhD
  1. *Division of Gynecologic Oncology, Victoria Hospital;
  2. Department of Obstetrics and Gynecology, Western University;
  3. Institute for Clinical Evaluative Sciences–Western Satellite Site (ICES Western);
  4. §Department of Medical Genetics, Victoria Hospital; and
  5. Department of Molecular Genetics, Western University, London; and
  6. Division of Gynecologic Oncology, McMaster University, Hamilton, Ontario, Canada.
  1. Address correspondence and reprint requests to Jacob McGee, MD, MPH, Gynecologic Oncology, London Health Sciences Centre, 800 Commissioners Rd E, London, Ontario, Canada N6A 5W9. E-mail: Jacob.mcgee@lhsc.on.ca.

Abstract

Objective In 2001, the province of Ontario expanded cancer genetic testing eligibility to include all women with high-grade serous ovarian carcinoma (HGSC) of the ovary, fallopian tube, and peritoneum. The aim of this study was to determine the proportion of women who attended genetics counseling for consideration of BRCA1/2 gene analysis. We also sought to examine if regional differences in consultation rate exist across administrative health regions in the province of Ontario.

Methods We identified all women with a pathological diagnosis of HGSC in the province of Ontario between 1997 until 2011. Our primary outcome was the 2-year rate of genetics consultation following a diagnosis of HGSC. We compared consultation rates over time and geographical regions and applied multiple logistic regression to identify predictors of genetics consultation.

Results Of the 5412 women with a diagnosis of HGSC over the study period, 6.6% were seen for genetics consultation within 2 years of diagnosis. Factors predictive of genetics consultation included history of breast cancer (odds ratio [OR], 3.56; 95% confidence interval [CI], 1.87–6.78), era of diagnosis (2009–2011 vs 1997–2000; OR, 10.59; 95% CI, 5.02–22.33), and younger age at diagnosis (OR, 0.95; 95% CI, 0.94–0.97 for each additional year). No regional differences in consultation rate were seen.

Conclusions Despite an increasing rate across eras, a small proportion of women with HGSC undergo genetics consultation. Efforts are required to increase cancer genetics consultation in patients with HGSC in the province of Ontario.

  • BRCA mutation
  • Genetics consultation
  • Ovarian carcinoma
  • Risk reducing

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Footnotes

  • This study was supported by ICES Western. ICES is funded by an annual grant from the Ontario Ministry of Health and Long-term Care. Core funding for ICES Western is provided by the Academic Medical Organization of Southwestern Ontario, the Schulich School of Medicine and Dentistry, Western University, and the Lawson Health Research Institute.

  • The authors declare no conflicts of interest.

  • The opinions, results, and conclusions reported in this article are those of the authors and are independent from the funding sources. No endorsement by ICES, Academic Medical Organization of Southwestern Ontario, Schulich School of Medicine and Dentistry, Lawson Health Research Institute, or the Ontario Ministry of Health and Long-term Care is intended or should be inferred. Parts of this material are based on data and information compiled and provided by the Canadian Institutes for Health Information and Cancer Care Ontario. All analyses, conclusions, opinions, and statements expressed herein are those of the author and do not necessarily those of the Canadian Institutes for Health Information or the Cancer Care Ontario.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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