Oncology Clinic-Based Hereditary Cancer Genetic Testing in a Population-Based Health Care System

Affiliations

PMID: 32028617
DOI: 10.3390/cancers12020338

Abstract

New streamlined models for genetic counseling and genetic testing have recently been developed in response to increasing demand for cancer genetic services. To improve access and decrease wait times, we implemented an oncology clinic-based genetic testing model for breast and ovarian cancer patients in a publicly funded population-based health care setting in British Columbia, Canada. This observational study evaluated the oncology clinic-based model as compared to a traditional one-on-one approach with a genetic counsellor using a multi-gene panel testing approach. The primary objectives were to evaluate wait times and patient reported outcome measures between the oncology clinic-based and traditional genetic counselling models. Secondary objectives were to describe oncologist and genetic counsellor acceptability and experience. Wait times from referral to return of genetic testing results were assessed for 400 patients with breast and/or ovarian cancer undergoing genetic testing for hereditary breast and ovarian cancer from June 2015 to August 2017. Patient wait times from referral to return of results were significantly shorter with the oncology clinic-based model as compared to the traditional model (403 vs. 191 days; p < 0.001). A subset of 148 patients (traditional n = 99; oncology clinic-based n = 49) completed study surveys to assess uncertainty, distress, and patient experience. Responses were similar between both models. Healthcare providers survey responses indicated they believed the oncology clinic-based model was acceptable and a positive experience. Oncology clinic-based genetic testing using a multi-gene panel approach and post-test counselling with a genetic counsellor significantly reduced wait times and is acceptable for patients and health care providers.

Keywords: genetic counselling; genetic testing; hereditary cancer; patient reported outcome measures.

Conflict of interest statement

Research and funding support was provided by AstraZeneca and research support was provided by BC Cancer and the University of British Columbia. AstraZeneca had no role in the design, execution, interpretation, or writing of this study. AstraZeneca requested the report be submitted for publication. Karsan reports personal fees from AstraZeneca, personal fees from Novartis, personal fees from Bristol-Myers Squibb, grants from AstraZeneca, outside the submitted work. Schrader reports grants from AstraZeneca, during the conduct of the study; personal fees from AstraZeneca, outside the submitted work. Schrader is also supported by the Michael Smith Foundation for Health Research and Canadian Institutes of Health Research. Sun reports grants from Astra Zeneca, during the conduct of the study; personal fees from Astra Zeneca, outside the submitted work. Regier has received travel support from Illumina to attend meetings in Boston MA and Barcelona Spain. All other authors report no conflicts of interest.