How to improve the identification of patients with cancer eligible for genetic counselling?

Eur J Cancer Care (Engl). 2020 Sep;29(5):e13276. doi: 10.1111/ecc.13276. Epub 2020 Jun 8.

Abstract

Objective: International guidelines recommend genetic counselling and if indicated the genetic testing for treatment, disease prevention and follow-up for patients and their relatives. However, there is limited utilisation of genetic counselling. This study aimed to verify whether an individual semi-structured guideline-based interview improves the identification of patients eligible for genetic counselling.

Methods: Unselected patients with cancer were interviewed. A dedicated nurse provided an ad-hoc guideline-based questionnaire to assess the presence of criteria for a possible hereditary breast and ovarian cancer syndrome or hereditary non-polyposis colorectal cancer syndrome (Lynch syndrome). The interest of patients to undergo genetic counselling was also investigated.

Results: Ninety patients were enrolled in the study; 20 (22.2%) of these had already undergone genetic counselling. The interview identified 23 (32.8%) of the remaining 70 patients that were eligible for genetic counselling. Two-third of the patients (n = 59) were interested in genetic counselling irrespective of socio-demographic factors or cancer type. A logistic regression analysis for age, gender, parental status, educational level and cancer type did not reveal any independent factor that was associated with patients who had previous genetic counselling.

Conclusions: Our preliminary findings suggest that a semi-structured guideline-based interview can substantially improve the identification of patients eligible for genetic counselling.

Keywords: Lynch syndrome; genetic counselling; genetic counsellor; genetic testing; hereditary breast and ovarian cancer syndrome; hereditary non-polyposis colorectal cancer syndrome.

MeSH terms

  • Colorectal Neoplasms, Hereditary Nonpolyposis* / diagnosis
  • Colorectal Neoplasms, Hereditary Nonpolyposis* / genetics
  • Female
  • Genetic Counseling
  • Genetic Testing
  • Hereditary Breast and Ovarian Cancer Syndrome*
  • Humans
  • Surveys and Questionnaires