Skip to main content

Clinical implementation of an oncology-specific family health history risk assessment tool.

Publication ,  Journal Article
Fung, SM; Wu, RR; Myers, RA; Goh, J; Ginsburg, GS; Matchar, D; Orlando, LA; Ngeow, J
Published in: Hered Cancer Clin Pract
March 20, 2021

BACKGROUND: The presence of hereditary cancer syndromes in cancer patients can have an impact on current clinical care and post-treatment prevention and surveillance measures. Several barriers inhibit identification of hereditary cancer syndromes in routine practice. This paper describes the impact of using a patient-facing family health history risk assessment platform on the identification and referral of breast cancer patients to genetic counselling services. METHODS: This was a hybrid implementation-effectiveness study completed in breast cancer clinics. English-literate patients not previously referred for genetic counselling and/or gone through genetic testing were offered enrollment. Consented participants were provided educational materials on family health history collection, entered their family health history into the platform and completed a satisfaction survey. Upon completion, participants and their clinicians were given personalized risk reports. Chart abstraction was done to identify actions taken by patients, providers and genetic counsellors. RESULTS: Of 195 patients approached, 102 consented and completed the study (mean age 55.7, 100 % women). Sixty-six (65 %) met guideline criteria for genetic counseling of which 24 (36 %) were referred for genetic counseling. Of those referred, 13 (54 %) participants attended and eight (33 %) completed genetic testing. On multivariate logistic regression, referral was not associated with age, cancer stage, or race but was associated with clinical provider (p = 0.041). Most providers (71 %) had higher referral rates during the study compared to prior. The majority of participants found the experience useful (84 %), were more aware of their health risks (83 %), and were likely to recommend using a patient-facing platform to others (69 %). CONCLUSIONS: 65 % of patients attending breast cancer clinics in this study are at-risk for hereditary conditions based on current guidelines. Using a patient-facing risk assessment platform enhances the ability to identify these patients systematically and with widespread acceptability and recognized value by patients. As only a third of at-risk participants received referrals for genetic counseling, further understanding barriers to referral is needed to optimize hereditary risk assessment in oncology practices. TRIAL REGISTRATION: NIH Clinical Trials registry, NCT04639934 . Registered Nov 23, 2020 -- Retrospectively registered.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Hered Cancer Clin Pract

DOI

ISSN

1731-2302

Publication Date

March 20, 2021

Volume

19

Issue

1

Start / End Page

20

Location

Poland

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fung, S. M., Wu, R. R., Myers, R. A., Goh, J., Ginsburg, G. S., Matchar, D., … Ngeow, J. (2021). Clinical implementation of an oncology-specific family health history risk assessment tool. Hered Cancer Clin Pract, 19(1), 20. https://doi.org/10.1186/s13053-021-00177-y
Fung, Si Ming, R Ryanne Wu, Rachel A. Myers, Jasper Goh, Geoffrey S. Ginsburg, David Matchar, Lori A. Orlando, and Joanne Ngeow. “Clinical implementation of an oncology-specific family health history risk assessment tool.Hered Cancer Clin Pract 19, no. 1 (March 20, 2021): 20. https://doi.org/10.1186/s13053-021-00177-y.
Fung SM, Wu RR, Myers RA, Goh J, Ginsburg GS, Matchar D, et al. Clinical implementation of an oncology-specific family health history risk assessment tool. Hered Cancer Clin Pract. 2021 Mar 20;19(1):20.
Fung, Si Ming, et al. “Clinical implementation of an oncology-specific family health history risk assessment tool.Hered Cancer Clin Pract, vol. 19, no. 1, Mar. 2021, p. 20. Pubmed, doi:10.1186/s13053-021-00177-y.
Fung SM, Wu RR, Myers RA, Goh J, Ginsburg GS, Matchar D, Orlando LA, Ngeow J. Clinical implementation of an oncology-specific family health history risk assessment tool. Hered Cancer Clin Pract. 2021 Mar 20;19(1):20.

Published In

Hered Cancer Clin Pract

DOI

ISSN

1731-2302

Publication Date

March 20, 2021

Volume

19

Issue

1

Start / End Page

20

Location

Poland

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis