Training courses on hereditary breast and ovarian cancer to strengthen cross-sectoral care in underserved areas

Objective: To strengthen cross-sectoral care by disseminating specialized knowledge about hereditary breast and ovarian cancer across underserved areas. Methods: We report on a training course about genetic counseling and testing of hereditary breast and ovarian cancer patients for gynecologists from certified cancer centers. In total, 50 gynecologists attended the course which was offered once annually between 2017 and 2019. Before and after the course, participants were asked to answer a self-assessment questionnaire and completed the training with a multiple-choice test. The results of the self-assessments and knowledge tests were analyzed to steadily improve the training. Results: The self-assessments imply a perceived increase in certainty regarding the inclusion criteria for specialized genetic counseling, pedigree analysis, and contents of the initial consultation. Both the knowledge tests and self-assessments showed that participants had difficulties in interpreting and differentiating between age-specific and lifetime risks. Conclusion: The courses successfully conveyed knowledge necessary to identify patients at risk and to provide timely genetic analyses even in rural areas. Practice implications: The results are a promising basis for creating additional training courses addressing specialists in hospitals and gynecological practices. Further education of physicians might improve crosssectoral cooperation and thereby enable specialized care supply in rural areas. (c) 2020 Elsevier B.V. All rights reserved.