Article Text

PDF
Uptake of testing for germline BRCA mutations in patients with non-mucinous epithelial ovarian cancers in Western Australia: a comparison of different genetic counseling methods
  1. Grace Stearnes1,
  2. Cassandra B Nichols2,
  3. Lyn Schofield2,
  4. Sarah O'Sullivan2,3,
  5. Nicholas Pachter2,4 and
  6. Paul A Cohen1,5
  1. 1Gynaecological Oncology, St John of God Hospital Bendat Family Comprehensive Cancer Centre, Perth, Western Australia, Australia
  2. 2Genetic Services of Western Australia, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia
  3. 3WOMEN Centre, West Leederville, Western Australia, Australia
  4. 4Division of Pharmacology and Division of Paediatrics and Child Health, University of Western Australia Faculty of Medicine Dentistry and Health Sciences, Crawley, Western Australia, Australia
  5. 5Division of Obstetrics and Gynaecology Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
  1. Correspondence to Dr Paul A Cohen, Gynaecological Oncology, St John of God Hospital Bendat Family Comprehensive Cancer Centre, Perth, WA 6008, Australia; paul.cohen{at}uwa.edu.au

Abstract

Introduction Patients with non-mucinous epithelial tubo-ovarian cancers should be referred for genetic testing because approximately 15% will carry an inherited mutation in the BRCA1 or BRCA2 cancer susceptibility genes. However, referral rates for genetic testing remain low. For patients who carry a BRCA mutation, failure to refer for genetic testing results in missed opportunities for therapy and prevention of future cancers in the patient and at-risk relatives. In Western Australia between July 2013 and June 2015, 40.6% of patients with non-mucinous epithelial tubo-ovarian cancers discussed at a statewide gynecologic oncology tumor board were referred for genetic testing. Our objective was to investigate the proportion of patients with non-mucinous epithelial tubo-ovarian cancers in Western Australia referred for BRCA1/2 testing from July 2015 to December 2017, following the introduction of mainstreaming and tele-counseling. A secondary aim was to compare the uptake of genetic testing between different genetic counseling modalities.

Methods Retrospective case series. All patients with high-grade non-mucinous epithelial tubo-ovarian cancers discussed at the weekly Western Australian gynecologic oncology tumor board meeting, between July 1, 2015 and December 31, 2017, and those referred for BRCA mutation testing, were ascertained.

Results A total of 343 women were eligible for referral; 63 patients were excluded, leaving 280 patients for analysis. 220/280 patients were referred for genetic testing (78.6%). There were no differences in uptake of genetic testing by mode of genetic counseling.

Discussion A significant increase in referrals of eligible patients for genetic testing was observed in 2015–2017 compared with 2013–2014. Although there were no differences in uptake of genetic testing by mode of counseling, mainstreaming and tele-counseling provide alternative options for patients that may lead to higher uptake of genetic testing.

  • cystadenocarcinoma, serous
  • fallopian tube neoplasms
  • ovarian cancer
  • BRCA mutation testing
View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors GS conceived the study, collected the data, co-wrote the first draft of the manuscript, and edited and approved the manuscript. CBN collected, verified and analyzed the data, and edited and approved the manuscript. LS edited and approved the manuscript. SOS collected and verified data and edited and approved the manuscript. NP edited and approved the manuscript. PAC conceived the study, analyzed the data, co-wrote the first draft of the manuscript, and edited and approved the manuscript.

  • 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.

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

  • Data sharing statement No data are available.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.