Highlights
- •The number of women with SOC referred for genetic counseling and seen for genetic testing increased from previous reports.
- •A significant number of BRCA1/2 carriers report no family history of breast or ovarian cancer.
- •Low tumor grade and late age of diagnosis are barriers to genetic counseling referral for women with SOC.
Abstract
Objective
Despite guidelines recommending that all women with invasive serous ovarian cancer
(SOC) are offered genetic testing, published referral and testing rates have been
poor. Many centers have implemented novel genetic counseling service delivery models
to increase testing rates. In light of increased awareness and implementation of small
process changes at our center, this study aims to establish baseline referral rates
and testing outcomes prior to diverging from the traditional model of care.
Methods
A list of women diagnosed with SOC at Princess Margaret Cancer Center (PM) between
2010 and 2016 was obtained from the PM Cancer Registry and cross-referenced against
the genetics database to determine referral rates and outcomes of genetic testing.
Results
Of 724 women with SOC, 68% were referred for genetic counseling, with an overall testing
rate of 61%. Higher referral rates were seen among women with younger ages at diagnosis
and high-grade tumors. Of women tested, 22% were found to have a pathogenic variant
in BRCA1/2 and 9% in another cancer gene. Notably, 24% of women with a pathogenic variant reported
no family history of breast or ovarian cancer.
Conclusion
Genetic counseling referral and testing rates for women with SOC are higher than previously
reported, yet barriers to referral remain. To maximize genetic testing rates and address
increasing patient volumes, clinics may be faced with integrating novel genetic counseling
delivery models. Findings from this study may serve as a more accurate baseline to
which large scale service delivery changes can be compared.
Keywords
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Article info
Publication history
Published online: June 03, 2020
Accepted:
May 10,
2020
Received:
March 10,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
