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Genet Med. 2015 Jan;17(1):43-50. doi: 10.1038/gim.2014.68. Epub 2014 Jun 19.

Characteristics associated with genetic counseling referral and BRCA1/2 testing among women in a large integrated health system.

Author information

1
Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA.
2
Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
3
National Center for Health Statistics, Office of Public Health Science Services, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.
4
Josephine Ford Cancer Center, Henry Ford Health System, Detroit, Michigan, USA.

Abstract

BACKGROUND:

Evidence shows underutilization of cancer genetics services. To explore the reasons behind this underutilization, this study evaluated characteristics of women who were referred for genetic counseling and/or had undergone BRCA1/2 testing.

METHODS:

An ovarian cancer risk perception study stratified 16,720 eligible women from the Henry Ford Health System into average-, elevated-, and high-risk groups based on family history. We randomly selected 3,307 subjects and interviewed 2,524 of them (76.3% response rate).

RESULTS:

Among the average-, elevated-, and high-risk groups, 2.3, 10.1, and 20.2%, respectively, reported genetic counseling referrals, and 0.8, 3.3, and 9.5%, respectively, reported having undergone BRCA testing. Personal breast cancer history, high risk, and perceived ovarian cancer risk were associated with both referral and testing. Discussion of family history with a doctor predicted counseling referral, whereas belief that family history influenced risk was the strongest BRCA testing predictor. Women perceiving their cancer risk as much higher than other women their age were twice as likely (95% confidence interval: 2.0-9.6) to report genetic counseling referral.

CONCLUSION:

In a health system with ready access to cancer genetic counseling and BRCA testing, women who were at high risk underutilized these services. There were strong associations between perceived ovarian cancer risk and genetic counseling referral, and between a belief that family history influenced risk and BRCA testing.

PMID:
24946155
PMCID:
PMC4522900
DOI:
10.1038/gim.2014.68
[Indexed for MEDLINE]
Free PMC Article

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