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Factors associated with referral and completion of genetic counseling in women with epithelial ovarian cancer
  1. Stephanie Alimena1,2,
  2. Lauren Scarpetti3,
  3. Erica L Blouch3,
  4. Linda Rodgers3,
  5. Kristen Shannon3,
  6. Marcela Del Carmen2,
  7. Annekathryn Goodman2,
  8. Whitfield B Growdon2,
  9. Eric Eisenhauer2 and
  10. Rachel Clark Sisodia2
  1. 1 Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA
  2. 2 Division of Gynecologic Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3 Center for Cancer Risk Assessment, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Stephanie Alimena, Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA 02115, USA; salimena{at}partners.org

Abstract

Objective The National Comprehensive Cancer Network recommends that all women diagnosed with epithelial ovarian cancer undergo genetic testing, as the diagnosis of pathogenic variants may inform cancer survival and impact treatment options. The objective of this study was to assess factors associated with referral to genetic counseling in women with epithelial ovarian cancer.

Methods A retrospective cohort study identified women with epithelial ovarian cancer from 2012 to 2017 at Massachusetts General Hospital and North Shore Medical Center, a community hospital affiliated with Massachusetts General Hospital. Multivariate logistic regression evaluated how race, age, stage, year of diagnosis, insurance status, family history of breast or ovarian cancer, and language relates to the receipt of genetic counseling.

Results Of the total 276 women included, 73.9% were referred for genetic screening, of which 90.7% attended a genetic counseling visit. Older women were less likely to undergo genetic counseling (age ≥70 years: OR 0.26, 95% CI 0.07–0.94, p=0.04). Women who died within 365 days of initial oncology consult rarely reached a genetic counselor (OR 0.05, 95% CI 0.01–0.24, p<0.001). Women with a family history of breast or ovarian cancer were more likely to undergo counseling (OR 3.27, 95% CI 1.74–6.15, p<0.001). There was no difference in receipt of genetic counseling by race, stage, year of diagnosis, insurance status, or language.

Conclusion Older women with epithelial ovarian cancer and those who died within 1 year of initiation of care were less likely to undergo recommended genetic counseling. Race, insurance status, and language were not identified as predictive factors, although we were limited in this assessment by small sample size.

  • ovarian cancer
  • gynecology
  • neoplasms
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Footnotes

  • Contributors Every author contributed substantially to the final manuscript and fulfills the requirements for full authorship.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Institutional Review Board at Massachusetts General Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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