Faculty Collaboration Database

A feasibility study of breast cancer genetic risk assessment in a federally qualified health center. Cancer 2018 Sep 15;124(18):3733-3741

Date

10/16/2018

Pubmed ID

30320429

Pubmed Central ID

PMC6214782

DOI

10.1002/cncr.31635

Scopus ID

2-s2.0-85054905203 (requires institutional sign-in at Scopus site)   24 Citations

Abstract

BACKGROUND: The US Preventive Services Task Force (USPSTF) endorses routine screening for genetic risk of breast and/or ovarian cancer as a component of primary health care. Implementation of this recommendation may prove challenging, especially in clinics serving disadvantaged communities.

METHODS: The authors tested the feasibility of implementing the USPSTF mandate at a federally qualified health center (FQHC) to identify women who were eligible for genetic counseling (GC). A 12-month usual-care phase was followed by a 12-month intervention phase, during which time cancer genetic risk assessment (CGRA) was systematically performed for all women aged 25 to 69 years who presented for an annual examination. Women who were eligible for GC were recruited to participate in the study.

RESULTS: After initiating CGRA, 112 women who were eligible for GC consented to study participation, and 56% of them received a referral for GC from their primary care physician. A subgroup of 50 participants were seen by the same primary care physician during both the usual-care and intervention phases. None of these patients was referred for GC during usual care, compared with 64% after the initiation of CGRA (P < .001). Only 16% of referred participants attended a GC session.

CONCLUSIONS: Implementing USPSTF recommendations for CGRA as a standard component of primary health care in FQHCs is feasible and improves referral of minority women for GC, but more work is needed to understand the beliefs and barriers that prevent many underserved women from accessing cancer genetic services.

Author List

Hoskins KF, Tejeda S, Vijayasiri G, Chukwudozie IB, Remo MH, Shah HA, Abraham IE, Balay LE, Maga TK, Searles ER, Korah VJ, Biggers A, Stolley MR, Warnecke RB

Author

Melinda Stolley PhD Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Breast Neoplasms
Chicago
Feasibility Studies
Female
Financing, Government
Genetic Counseling
Genetic Testing
Health Plan Implementation
Health Status Disparities
Humans
Mass Screening
Middle Aged
Ovarian Neoplasms
Physicians, Primary Care
Practice Patterns, Physicians'
Preventive Health Services
Primary Health Care
Program Evaluation
Referral and Consultation
Risk Assessment
United States