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Genet Test Mol Biomarkers. 2016 Oct;20(10):569-578. Epub 2016 Aug 15.

Evolution of Hereditary Breast Cancer Genetic Services: Are Changes Reflected in the Knowledge and Clinical Practices of Florida Providers?

Author information

1
1 Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute , Tampa, Florida.
2
2 Department of Global Health, University of South Florida , Tampa, Florida.
3
3 Department of Communication Studies, Northwestern University , Chicago, Illinois.

Abstract

AIMS:

We describe practitioner knowledge and practices related to hereditary breast and ovarian cancer (HBOC) in an evolving landscape of genetic testing.

METHODS:

A survey was mailed in late 2013 to Florida providers who order HBOC testing. Descriptive statistics were conducted to characterize participants' responses.

RESULTS:

Of 101 respondents, 66% indicated either no genetics education or education through a commercial laboratory. Although 79% of respondents were aware of the Supreme Court ruling resulting in the loss of Myriad Genetics' BRCA gene patent, only 19% had ordered testing from a different laboratory. With regard to pretest counseling, 78% of respondents indicated they usually discuss 11 of 14 nationally recommended elements for informed consent. Pretest discussion times varied from 3 to 120 min, with approximately half spending <20 min. Elements not routinely covered by >40% of respondents included (1) possibility of a variant of uncertain significance (VUS) and (2) issues related to life/disability insurance. With regard to genetic testing for HBOC, 88% would test an unaffected sister of a breast cancer patient identified with a BRCA VUS.

CONCLUSIONS:

Results highlight the need to identify whether variability in hereditary cancer service delivery impacts patient outcomes. Findings also reveal opportunities to facilitate ongoing outreach and education.

KEYWORDS:

BRCA; genetic knowledge; genetic service delivery; genetic testing; hereditary breast cancer

PMID:
27525501
DOI:
10.1089/gtmb.2016.0113
[Indexed for MEDLINE]

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