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Delivery of hereditary cancer genetics services to patients newly diagnosed with ovarian and endometrial cancers at three gynecologic oncology clinics in the USA, Brazil, and Mexico
  1. Erica M Bednar1,
  2. Keiry A Paiz2,
  3. Karen H Lu2,
  4. Aline Patricia Soares Dias De Souza3,
  5. Gabriela Oliveira3,
  6. Carlos e Eduardo Mattos da Cunha Andrade3,
  7. Lenny Gallardo4,
  8. Jairo Rubio-Cordero4,
  9. David Cantu-de-León4 and
  10. Jose Alejandro Rauh-Hain2
    1. 1Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
    2. 2Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
    3. 3Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, Brazil
    4. 4Clinical Research, Instituto Nacional de Cancerologia, Mexico City, Mexico
    1. Correspondence to Erica M Bednar, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; embednar{at}mdanderson.org

    Abstract

    Objective Three gynecologic oncology clinics located in the USA, Brazil, and Mexico collaborated to evaluate their delivery of hereditary cancer genetics services. This descriptive retrospective review study aimed to establish baseline rates and timeliness of guideline-recommended genetics service delivery to patients with ovarian, fallopian tube, primary peritoneal (ovarian), and endometrial cancers at each clinic.

    Methods Patients who were newly diagnosed with ovarian and endometrial cancers between September 1, 2018 and December 31, 2020 were identified from the medical records of the clinics. Genetics service delivery metrics included the rates of mismatch repair deficiency tumor testing for patients with endometrial cancer (microsatellite instability/immunohistochemistry, MSI/IHC), referral to genetics services for patients with ovarian cancer, completed genetics consultations, and germline genetic testing for patients with ovarian and endometrial cancers. Timeliness was calculated as the average number of days between diagnosis and the relevant delivery metric. Descriptive statistics were used to analyze data.

    Results In total, 1195 patients (596 with ovarian cancer, 599 with endometrial cancer) were included in the analysis, and rates of genetics service delivery varied by clinic. For patients with ovarian cancer, referral rates ranged by clinic from 32.6% to 89.5%; 30.4–65.1% of patients completed genetics consultation and 32.6–68.7% completed genetic testing. The timeliness to genetic testing for patients with ovarian cancer ranged by clinic from 107 to 595 days. A smaller proportion of patients with endometrial cancer completed MSI/IHC testing (10.0–69.2%), with the average time to MSI/IHC ranging from 15 to 282 days. Rates of genetics consultation among patients with endometrial cancer ranged by clinic from 10.8% to 26.0% and 12.5–16.6% completed genetic testing.

    Conclusions All clinics successfully established baseline rates and timeliness of delivering hereditary cancer genetics services to patients with ovarian and endometrial cancers. Lower rates of delivering genetics services to patients with endometrial cancer warrant additional research and quality improvement efforts.

    • Carcinoma, Ovarian Epithelial
    • Endometrial Neoplasms

    Data availability statement

    Data are available upon reasonable request. In accordance with the journal’s guidelines, we will provide our data for independent analysis by a selected team by the Editorial Team for the purposes of additional data analysis or for the reproducibility of this study in other centers if such is requested, and per sites’ data use agreement policies.

    https://doi.org/10.1136/ijgc-2023-005190

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      Data availability statement

      Data are available upon reasonable request. In accordance with the journal’s guidelines, we will provide our data for independent analysis by a selected team by the Editorial Team for the purposes of additional data analysis or for the reproducibility of this study in other centers if such is requested, and per sites’ data use agreement policies.

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      Footnotes

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      • Presented at Preliminary data from this manuscript were presented as a poster at the UT Austin and MD Anderson Collaborative Research Summit meeting November 15, 2023.

      • Contributors All authors contributed substantially to the design, implementation, and analysis of the described study. All authors have reviewed and approved the manuscript content and agree to be accountable for all aspects of the work. Study Guarantors: EMB, JAR-H. Study concept, methodology, and project administration: EMB, CeEMdCA, DC-d-L, JAR-H. Funding acquisition: JAR-H, KHL. Investigation and data curation: EMB, KAP, APSDDS, GO, CeEMdCA, JR-C, DC-d-L. Formal analysis: EMB. Writing – original draft: EMB. Writing - review and editing: EMB, KAP, KHL, APSDDS, GO, CeEMdCA, LG, JR-C, DC-d-L, JAR-H.

      • Funding This research was supported by funds from the University Cancer Foundation via the Sister Institution Network Fund at The University of Texas MD Anderson Cancer Center. EMB’s work is supported by the University of Texas MD Anderson Cancer Center Moon Shots Program, Cancer Prevention & Control Platform.

      • Competing interests The following authors declare no potential conflict of interest: EMB, KAP, KHL, APSDDS, GO, CeEMdCA, LG, JR-C, DC-d-L. JAR-H reports consulting fees from Guidepoint Consulting and Schlesinger Group.

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