Health Care Provider Perceptions of Caring for Individuals with Inherited Pancreatic Cancer Risk.

Underhill ML1, Pozzar R2, Chung D3, Sawhney M4, Yurgelun M2.

Author information

1: Dana-Farber Cancer Institute, 450 Brookline Ave, LW522, Boston, MA, 02215, USA. meghanl_underhill@dfci.harvard.edu.
2: Dana-Farber Cancer Institute, 450 Brookline Ave, LW522, Boston, MA, 02215, USA.
3: Massachusetts General Hospital, Boston, USA.
4: Beth Israel Deaconess Medical Center, Boston, USA.

Abstract

Recent national guidelines recommend genetic risk assessment for all patients diagnosed with pancreatic cancer, yet individuals with pancreatic cancer obtain genetic testing at suboptimal rates. Both patient and provider factors play a role in adherence to genetic testing recommendations. The purpose of this study was to understand health care provider perspectives of caring for patients with inherited pancreatic cancer risk. The study was a cross-sectional mixed method study utilizing a qualitative interview and a survey. The study sample included health care providers who provide care for patients with pancreatic cancer or inherited risk. Qualitative data were analyzed using content analysis, while quantitative data were summarized using descriptive statistics. Thirty participants had complete interview data and 29 completed a survey. The sample was comprised of physicians (n = 17), genetic counselors (n = 6), nurses (n = 3), and social workers (n = 3). Respondents were less confident in their ability to identify patients with inherited pancreatic cancer risk compared with other hereditary cancer syndromes. Several challenges were identified including the pancreatic cancer illness trajectory; lack of evidence-based practice guidelines; difficulty interpreting genetic test results; and difficulty following up on referrals. Participants perceived a lack of educational resources for patients with inherited pancreatic cancer risk. Health care providers who care for individuals with inherited pancreatic cancer risk face challenges that are distinct from those encountered during the care of individuals for other hereditary cancers. There is a need for additional resources at the patient-, provider-, and system-level.