Abstract A48: Enhancing cancer genomics practice in public health departments to identify women at high risk for hereditary breast and ovarian cancer syndrome (HBOC)

Abstract

Abstract In order to increase knowledge and appropriate genetic assessment, an education and screening plan was developed on concepts relating to Hereditary Breast and Ovarian Cancer Syndrome (HBOC) for use in Georgia Public Health departments. Focus centered on the use Breast Cancer Genetics Referral Screening tool (B-RST) located online at www.BreastCancerGeneScreen.org. Limited knowledge of hereditary risk factors and family history are barriers to appropriate identification of young women at risk for HBOC. The educational module's implementation plan utilizes existing public health cancer screening and family planning programs to offer risk assessment and instruction on HBOC for underserved populations. The Georgia Breast Cancer Genomic Consortium is a service project that performs the surveillance of women enrolled in these existing public health programs. The Consortium provides genetic education for women at risk for HBOC based on the B-RST and secures genetic testing for women considered high risk to determine if they are carriers of the BRCA 1 or 2 gene mutations. The project addresses populations of young women in Georgia between the ages of 18-49 by collaborating with the state Public Health infrastructure, Georgia Center for Oncology Research and Education, Emory University, Morehouse School of Medicine and Georgia State University's strategic partners and existing cancer resources. The target population aligns with Healthy People data collection metrics and focuses on both African Americans and young female Jewish populations in targeted areas of the state. The Behavioral Ecological Model served as a theoretical framework for the project due to the diverse social, interpersonal and behavioral factors that influence women at high risk for HBOC. Intervention at the institutional level through public health clinical settings also allowed greater access to the affected population and the opportunity for population level change. The module on HBOC was delivered to Public Health nurses in six Georgia counties. A total of 74 nurse and supporting health department staff participated in the project's educational sessions. The educational module was shown to effectively increased HBOC knowledge; enhancing the health care provider's ability to properly refer high risk patients for genetic counseling. Patients that screened positive according the tool were contacted by phone to complete a family health history assessment with an advanced practice nurse in genetics. As of September 2013, 1591 women have been screened within six public health districts representing 24 of Georgia's 159 counties. 73.9% (n=1175) of participants self-identified as African American/Black, followed by 13.6% (n=216) Caucasian/White and 6.5% (n=104) Hispanic/Latino. The introduction of genomics practice within public health departments represents the future of cancer care through the provision of genetic testing and counseling to uninsured individuals. This may result in increased access to comprehensive cancer care for minority populations. Citation Format: Monique L. Martin, Alice Kerber. Enhancing cancer genomics practice in public health departments to identify women at high risk for hereditary breast and ovarian cancer syndrome (HBOC). [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A48. doi:10.1158/1538-7755.DISP13-A48