Exploring Stakeholders' Perspectives on Implementing Universal Germline Testing for Colorectal Cancer: Findings From a Clinical Practice Survey-Reference-Cited by-同舟云学术

Exploring Stakeholders' Perspectives on Implementing Universal Germline Testing for Colorectal Cancer: Findings From a Clinical Practice Survey

Published:2023-09 Issue:7 Volume: Page:
ISSN:2473-4284
Container-title:JCO Precision Oncology
language:en
Short-container-title:JCO Precision Oncology

Author:

Rodgers-Fouche Linda¹^ORCID,Arora Sanjeevani²,Ricker Charité³,Li Dan⁴^ORCID,Farooqi Maheen⁵,Balaguer Francesc⁶^ORCID,Dominguez-Valentin Mev⁷^ORCID,Guillem Jose G.⁸^ORCID,Kanth Priyanka⁹^ORCID,Liska David¹⁰^ORCID,Melson Joshua¹¹,Mraz Kathryn A.¹²^ORCID,Shirts Brian H.¹³^ORCID,Vilar Eduardo¹⁴^ORCID,Katona Bryson W.¹⁵^ORCID,Hodan Rachel¹⁶^ORCID

Affiliation:

1. Center for Cancer Risk Assessment, Massachusetts General Hospital, Boston, MA

2. Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA

3. Division of Medical Oncology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA

4. Department of Gastroenterology, Kaiser Permanente Medical Center, Santa Clara, CA

5. Division of Medical Oncology, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA

6. Department of Gastroenterology, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain

7. Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Oslo, Norway

8. Department of Surgery, University of North Carolina, Chapel Hill, NC

9. Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, DC

10. Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH

11. Division of Gastroenterology, University of Arizona Cancer Center, Tucson, AZ

12. Grey Genetics, Brooklyn, NY

13. Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA

14. Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX

15. Division of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA

16. Cancer Genetics, Stanford Health Care, Palo Alto, CA

Abstract

PURPOSE New guidelines recommend considering germline genetic testing for all patients with colorectal cancer (CRC). However, there is a lack of data on stakeholders' perspectives on the advantages and barriers of implementing universal germline testing (UGT). This study assessed the perspectives of members of the Collaborative Group of the Americas on Inherited Gastrointestinal Cancer (CGA-IGC) regarding the implementation of UGT for patients with CRC, including readiness, logistics, and barriers. METHODS A cross-sectional survey was sent to 317 active members of CGA-IGC. The survey included sections on demographics, clinical practice specialty, established institutional practices for testing, and questions pertaining to support of and barriers to implementing UGT for patients with CRC. RESULTS Eighty CGA-IGC members (25%) participated, including 42 genetic counselors (53%) and 14 gastroenterologists (18%). Forty-seven (59%) reported an academic medical center as their primary work setting, and most participants (56%) had more than 10 years of clinical practice. Although most participants (73%) supported UGT, 54% indicated that changes in practice would be required before adopting UGT, and 39% indicated that these changes would be challenging to implement. There was support for both genetics and nongenetics providers to order genetic testing, and a majority (57%) supported a standardized multigene panel rather than a customized gene panel. Key barriers to UGT implementation included limited genetics knowledge among nongenetics providers, time-consuming processes for obtaining consent, ordering tests, disclosing results, and lack of insurance coverage. CONCLUSION This study demonstrates wide support among hereditary GI cancer experts for implementation of UGT for patients with CRC. However, alternative service delivery models using nongenetics providers should be considered to address the logistical barriers to UGT implementation, particularly the growing demand for genetic testing.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

Link

https://ascopubs.org/doi/pdfdirect/10.1200/PO.23.00440

Reference33 articles.

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2. Germline Cancer Susceptibility Gene Testing in Unselected Patients With Colorectal Adenocarcinoma: A Multicenter Prospective Study

3. Prevalence and Spectrum of Germline Cancer Susceptibility Gene Mutations Among Patients With Early-Onset Colorectal Cancer