Highlights
- •Embedding a GC resulted in greater completion and timeliness of genetic counseling.
- •An embedded GC promoted genetic testing for ovarian cancer patients irrespective of age at diagnosis or family history.
- •Improvements in GC access through this model were sustained over time.
Abstract
Objective
Germline genetic testing is crucial to the care of ovarian cancer patients, and as
part of the guideline-based care for ovarian cancer patient's adherence to this recommendation
has been low. We sought to determine whether embedding a genetic counselor (GC) within
a medical and gynecologic oncology clinic would increase testing rates and improve
the timeliness of testing.
Methods
Prospective cohort study of 358 ovarian cancer patients seen by medical and gynecologic
oncologists between 2013 and 2015. Rates of referrals, completion of counseling, and
genetic testing and timeliness of counseling were abstracted before and after a GC
was embedded in the clinic in 2014. An additional year of data (2015) was collected
to evaluate sustainability of the intervention.
Results
Between 2013 and 2015, 88–92% of women were referred for genetic testing, but in 2013
only 66% completed counseling and 61% were tested. After a GC was embedded in the
clinic in 2014, more than 80% of referred women completed counseling and germline
genetic testing. Time to genetic counseling also decreased from a median of 107 to
40 days, irrespective of age and cancer family history (p < 0.01).
Conclusions
Embedding a GC into the workflow for ovarian cancer patients is an effective way of
improving access to genetic counseling, testing rates, and the timeliness of testing.
Keywords
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Article info
Publication history
Published online: November 21, 2020
Accepted:
November 4,
2020
Received:
August 28,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
