The 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

被引:7
作者
Drescher, Charles W. [1 ]
Beatty, J. David [1 ,2 ]
Resta, Robert [2 ,3 ]
Andersen, M. Robyn [1 ]
Watabayashi, Kate [1 ]
Thorpe, Jason [1 ]
Hawley, Sarah [1 ]
Purkey, Hannah [1 ]
Chubak, Jessica [4 ,5 ]
Hanson, Nancy [2 ,3 ]
Buist, Diana S. M. [4 ,5 ,6 ]
Urban, Nicole [1 ,6 ]
机构
[1] Fred Hutchinson Canc Res Ctr, Translat Outcomes Res, Publ Hlth Sci, 1124 Columbia St, Seattle, WA 98104 USA
[2] Swedish Med Ctr, Swedish Canc Inst, Seattle, WA USA
[3] Swedish Med Ctr, Hereditary Canc Clin, Seattle, WA USA
[4] Grp Hlth Res Inst, Seattle, WA USA
[5] Univ Washington, Sch Publ Hlth, Dept Epidemiol, Seattle, WA 98195 USA
[6] Univ Washington, Sch Publ Hlth, Dept Hlth Serv, Seattle, WA 98195 USA
基金
美国国家卫生研究院;
关键词
genetic counseling; genetic testing; ovarian cancer; referral and consultation; risk assessment; surgical prevention; REDUCING SALPINGO-OOPHORECTOMY; HEREDITARY BREAST-CANCER; FAMILY-HISTORY; LYNCH-SYNDROME; MUTATIONS; CARRIERS; BRCA1/2; RECOMMENDATIONS; PREDICTORS; MANAGEMENT;
D O I
10.1002/cncr.30190
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUNDGuidelines recommend genetic counseling and testing for women who have a pedigree suggestive of an inherited susceptibility for ovarian cancer. The authors evaluated the effect of referral to genetic counseling on genetic testing and prophylactic oophorectomy in a randomized controlled trial. METHODSData from an electronic mammography reporting system identified 12,919 women with a pedigree that included breast cancer, of whom 625 were identified who had a 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). RESULTSParticipants were predominantly aged 45 to 65 years, and 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 < .005), respectively. Five women in the intervention arm and 2 in the control arm were identified as germline mutation carriers. Ten women in the intervention arm and 3 in the control arm underwent prophylactic bilateral salpingo-oophorectomy (P < .05). CONCLUSIONSRoutine referral of women at high risk for ovarian cancer to genetic counseling promotes genetic testing and prophylactic surgery. The findings from the current randomized controlled trial demonstrate the value of implementing strategies that target women at high risk for ovarian cancer to ensure they are offered access to recommended care. CA Cancer J Clin 2016. (c) 2016 American Cancer Society, Inc. Cancer 2016;122:3509-3518. (c) 2016 American Cancer Society
引用
收藏
页码:3509 / 3518
页数:10
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