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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
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11 15 2016
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Source: Cancer. 122(22):3509-3518
[PDF-402.19 KB]
Details:
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Alternative Title:Cancer
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Personal Author:
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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.
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Pubmed ID:27447168
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Pubmed Central ID:PMC5253334
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Volume:122
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Issue:22
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