Abstract
<h3>Objectives:</h3> In 2014, the Society of Gynecologic Oncology (SGO) published guidelines regarding universal germline testing for women with ovarian, fallopian tube, or primary peritoneal cancers (Ov/FT/PC) cancer. The purpose of this study was to determine the rate of referral to- and completion of genetic testing after diagnosis of Ov/FT/PC in patients treated at a rural tertiary care center. The effect of time and distance traveled on completion of genetic consultation was also examined. <h3>Methods:</h3> This is a retrospective cohort study of women with a diagnosis of Ov/FT/PC cancers receiving care at the University of Vermont Medical Center (UVMMC) from October 2014 to November 2019. Clinical information was obtained from the UVMMC Cancer registry and electronic medical records. Median income by zip code was obtained from US census data while time and distance traveled was based on the Google Application Interface software. Data was analyzed with two-sample Wilcoxon tests and Chi-square analysis. <h3>Results:</h3> 151 patients were identified. Mean age at diagnosis was 62 years (23 - 88). Median income was $64,611 and BMI was 29. Eighty (53%) patients had a genetics referral placed while 71 (47%) did not. Of the 80 patients referred, 68 (85%) completed their consultation. Referral rates significantly increased over time, (p<0.001). Genetic consultation completion rates were similar over time, (p=0.578). Mean time traveled was 42 minutes (3 - 188), and mean distance traveled was 28 miles (0 - 154). Time and distance traveled were not significantly associated with completion of genetics consultation. <h3>Conclusions:</h3> While referral rates increased steadily over time, nearly half of the patients with Ov/FT/PC cancer were not referred for genetic consultation. The majority of patients, who were referred to genetics, completed their consultation regardless of time or distance traveled. Mechanisms to ensure timely referral for genetic testing need to be implemented as they can affect treatment.
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