Patterns and predictors of genetic referral among ovarian cancer patients at a National Cancer Institute‐Comprehensive Cancer Center

• Published in: Clinical genetics 2020-02, Vol.97 (2), p.370-375
• Main Authors: Mallen, Adrianne R., Conley, Claire C., Townsend, Mary K., Wells, Ali, Boac, Bernadette M., Todd, Sarah, Gandhi, Anjalika, Kuznicki, Michelle, Augusto, Bianca M., McIntyre, McKenzie, Fridley, Brooke L., Tworoger, Shelley S., Wenham, Robert M., Vadaparampil, Susan T.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; BRCA1 protein; BRCA1 Protein - genetics; BRCA1/2; BRCA2 Protein - genetics; Chemotherapy; Demography; Electronic medical records; Family medical history; Female; genetic counseling; Genetic Predisposition to Disease; Genetic screening; genetic testing; Genetic Testing - standards; Genetics; germline mutation; Health Personnel; Humans; Insurance Carriers; Logistic Models; Middle Aged; National Cancer Institute (U.S.); Ovarian cancer; Ovarian Neoplasms - genetics; Ovarian Neoplasms - mortality; Ovarian Neoplasms - physiopathology; Ovarian Neoplasms - therapy; Patients; Platinum; Quality control; Referral and Consultation - statistics & numerical data; Regression analysis; Retrospective Studies; Survival; United States; White People - genetics
• ISSN: 0009-9163; 1399-0004
• DOI: 10.1111/cge.13654

Germline mutations (eg, BRCA1/2) have prognostic and treatment implications for ovarian cancer (OVCA) patients. Thus, national guidelines recommend genetic testing for OVCA patients. The present study examines patterns and predictors of genetics referral in OVCA patients. Electronic medical record data were ed retrospectively from 557 OVCA patients treated from 1 January 2001 to 31 December 2015. Logistic regression models identified sociodemographic characteristics, disease/treatment characteristics, family history data, provider characteristics, and survival data that predicted genetics referral. Overall, 27.5% of patients received referral. Eleven variables predicting referral were selected during stepwise regression: younger age, White race, not having private insurance, professional school education, year of OVCA diagnosis, platinum sensitivity, female gynecologic oncologist, chemotherapy administered by a gynecologic oncologist, clinical trial enrollment, longer overall survival, and family history of OVCA. Genetics referral among OVCA patients was similar to rates reported nationwide. Unique predictive factors will contribute to quality improvement and should be validated at a multi‐institutional level to ensure guideline concordant care is provided to all OVCA patients. Future research should identify both patient‐level and provider‐level factors associated with genetics referral.