RT Journal Article
SR Electronic
T1 A Comprehensive Program Enabling Effective Delivery of Regional Genetic Counseling
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 996
OP 1002
DO 10.1097/IGC.0000000000001256
VO 28
IS 5
A1 Jubilee Brown
A1 Aly Athens
A1 David L. Tait
A1 Erin K. Crane
A1 Robert V. Higgins
A1 R. Wendel Naumann
A1 Lejla Hadzikadic Gusic
A1 Lisa Amacker-North
YR 2018
UL http://ijgc.bmj.com/content/28/5/996.abstract
AB Objectives The aim of this study was to demonstrate the utility of a comprehensive program involving management-based evidence, telemedicine, and patient navigation to provide genetic counseling services for patients with ovarian and breast cancer across a geographically large health care system.Methods We identified all patients with newly diagnosed ovarian and breast cancer in our health care system from January 2013 to December 2015 through the cancer registry. Referral characteristics and testing outcomes were recorded for each year and compared using the χ2 or Fisher exact test.Results Because the implementation of this program, the number of new ovarian cancer cases remained constant (109–112 cases/year) but patients referred for genetic counseling increased annually from 37% to 43% to 96% (P < 0.05). The percentage of ovarian cancer patients who underwent genetic testing increased annually from 24% to 27% to 53% (P < 0.05). The number of new breast cancer patients was constant (1543–1638 cases/year). The percentage of patients with triple negative breast cancer referred for genetic counseling rose from 69% in 2013 to 91% in 2015; the percentage of patients who underwent testing increased annually from 59% to 86% (P < 0.05). Of women with breast cancer diagnosed at less than 45 years of age, 78% to 85% were referred for genetic counseling across this period; the percentage of patients who underwent testing increased annually from 66% to 82% (P < 0.05). Patient navigation was initiated and was available to all patients in the system during this period. Telemedicine consults were performed in 118 breast/ovarian patients (6%) during this period.Conclusions A comprehensive program may improve access to effective genetic counseling services in patients with ovarian and breast cancer despite geographic barriers.