Highlights
- •Hospital-based Traceback results in minimal uptake of genetic counseling and genetic testing services.
- •Hospital-based Traceback is time intensive and may burden an already busy clinical practice.
- •Biological relatives were more likely than unrelated contact persons to respond positively to telephone contact.
- •Offering genetic counseling and testing services during active oncology may be the most effective strategy to ensure uptake.
Abstract
Objective
To determine the feasibility of hospital-based genetic counseling and testing (GC/T)
Traceback for Ovarian Cancer (OC) patients, as proposed by the Division of Cancer
Prevention and the Division of Cancer Control and Population Sciences, National Cancer
Institute.
Methods
Living patients with OC were sent a letter explaining the availability of guideline-supported
GC/T for at least BRCA1/2 and surrogates of deceased patients were called on the telephone. Outcomes of contact
attempts were systematically recorded and statistically described.
Results
598 Traceback-eligible OC patients diagnosed from 2006 to 2016 were identified (163
presumed-living and 435 deceased). Two living patients called our office and scheduled
an appointment for GC/T after receiving a letter. For surrogates of prior patients,
successful contact occurred in 25% of call attempts. Fourteen individuals (2 living
patients and 12 surrogates) underwent genetic counseling. Of those 14, 10 individuals
consented to genetic testing and 5 followed through with sample collection. None of
these individuals had pathogenic variants (PVs). When surrogate call notes were reviewed,
58% reflected positive responses to contact, however 42% were noted to have negative
or indifferent responses, which were most common among spouses. Total time spent for
hospital-based Traceback was 109 h.
Conclusions
Overall, hospital-based Traceback via letter and telephone contact of surrogates is
time-intensive and results in minimal uptake of GC/T. To practically execute this
type of outreach program, health systems should consider collection of alternative
contact information to allow for electronic communication of patient surrogates. Our
study also underscores the importance of timely GC/T while patients are in active
cancer care.
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Article info
Publication history
Published online: January 05, 2022
Accepted:
December 21,
2021
Received in revised form:
December 18,
2021
Received:
October 5,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
