Hereditary cancer family history risk assessment outcomes in an obstetrics and gynecology population.

Lofquist F1, Lee C, Moyes K, Hamilton SA, Nelson J, Garner E.

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Abstract

INTRODUCTION:

The purpose of this study was to determine the prevalence of personal and family history of cancer in general obstetrics-gynecology practices and to identify reasons obstetrics-gynecology patients either accept or decline recommended genetic testing.

METHODS:

Patients presenting for gynecologic care during a 19-week period were invited to enroll in the study. Patients completed cancer family history questionnaires; those with family histories meeting guidelines for genetic testing received counseling and were offered same-day genetic testing. Patients were also asked the reasons why testing was accepted or declined. Genetic testing included analysis of BRCA1, BRCA2, MLH1, MSH2, MSH6, MYH, EPCAM, and PMS2.

RESULTS:

During the data collection period, 88.6% (716/808) of patients participated in the study and completed a family history questionnaire. All family history questionnares were reviewed by the study physician. Seventy-nine percent of patients (566/716) reported a personal or family history of cancer. A total of 14.6% (105/716) met National Comprehensive Cancer Network or Society of Gynecologic Oncology criteria for genetic testing. Genetic testing was recommended in 48 of the 105 patients and 38 of the 48 were tested same day. Of these 38 patients, 95.2% reported a high degree of understanding regarding hereditary cancer and genetic testing and 80.9% reported a high degree of satisfaction with the process of genetic testing.

CONCLUSIONS:

There is a substantial prevalence of patients with family histories meeting hereditary cancer genetic testing guidelines in a community obstetrics-gynecology setting. The majority of patients offered testing reported a high degree of understanding and satisfaction. The hereditary cancer risk assessment process used in this practice can serve as a model for other obstetrics-gynecology providers.