Effect of Referral for Genetic Counseling on Genetic Testing and Surgical Prevention in Women at High Risk for Ovarian Cancer-Results from a Randomized Controlled Trial

Details

• Alternative Title:
  Cancer
• Personal Author:
  Drescher, Charles W. ; Beatty, J. David ; Resta, Robert ; Andersen, M Robyn ; Watabayashi, Kate ; Thorpe, Jason ; Hawley, Sarah ; Purkey, Hannah ; Chubak, Jessica ; Hanson, Nancy ; Buist, Diana S.M. ; Urban, Nicole
  More +
• Description:
  Background ; Guidelines recommend genetic counseling and testing for women with a pedigree suggestive of an inherited susceptibility for ovarian cancer. We evaluated the effect of referral to genetic counseling on genetic testing and prophylactic oophorectomy via a randomized controlled trial. ; Methods ; Data from an electronic mammography reporting system identified 12,919 women with a pedigree including breast cancer, of whom 625 were identified as high risk for inherited susceptibility to ovarian cancer using a risk assessment questionnaire. Of these, 458 women provided informed consent and were randomized 1:1 to intervention consisting of a genetic counseling referral (n=228) or standard clinical care (n=230). ; Results ; Participants were predominantly aged 45 to 65; 30% and 20% reported a personal history of breast cancer or a family history of ovarian cancer, respectively. Eighty-five percent of women in the intervention group participated in a genetic counseling session. Genetic testing was reported by 74 (33%) and 20 (9%) women in the intervention and control arms (p<0.005) respectively. Five women in the intervention arm and two women in the control arm were identified as germline mutation carriers. Ten women in the intervention arm and three women in the control arm underwent prophylactic BSO (p<0.05). ; Conclusion ; Routine referral of women at high risk for ovarian cancer to genetic counseling promotes genetic testing and prophylactic surgery. Our findings from a randomized controlled trial demonstrate the value of implementing strategies targeting women at high risk for ovarian cancer to ensure they are offered access to recommended care.
• Keywords:
  • Ovarian cancer
  • Surgical prevention
  • Genetic counseling
  • Referral and Consultation
  • Risk Assessment and Genetic Testing
• Source:
  Cancer. 122(22):3509-3518
• Pubmed ID:
  27447168
• Pubmed Central ID:
  PMC5253334
• Document Type:
  Journal Article
• Funding:
  P50 CA083636/CA/NCI NIH HHSUnited States/ ; R18 DP001142/DP/NCCDPHP CDC HHSUnited States/ ; P50CA083636/National Institutes of Health/National Cancer Institute/ ; 1R18DP001142/Centers for Disease Control and Prevention/
• Volume:
  122
• Issue:
  22
• Download URL:
  https://stacks.cdc.gov/view/cdc/43933/cdc_43933_DS1.pdf
• File Type:
  [PDF - 402.19 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:4f962d9fb0afaa670dfbf32a2b801d18e7dd14960d36d74b9e318af691e67978