Genetic evaluations and testing rates for hereditary breast and ovarian cancer syndrome in a community oncology setting.

Abstract

e22533 Background: Several professional medical societies recommend genetic evaluations and testing for individuals with a personal and/or family cancer history. The National Comprehensive Cancer Network (NCCN) outlines germline testing criteria for breast, ovarian, and pancreatic cancer predisposition genes. This study aims to assess the genetic evaluation and testing rates in community oncology centers among patients who qualify based on their personal history of cancer. Methods: A retrospective study assessed patients diagnosed at any Texas Oncology site between 1/01/2017 and 12/31/2019. Using NCCN Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic V1.2020, individuals with the following cancer diagnoses were included: epithelial ovarian, breast < 45 years, triple negative breast < 60 years, metastatic HER2 negative breast, male breast, exocrine pancreatic, or metastatic prostate. Data was obtained from electronic medical records. The project was approved by the Texas Oncology Privacy Board. Results: Of the 10,202 patients included, 6033 (59%) underwent genetic testing. Only 3660 (36%) had a genetic evaluation, and of those, 2720 (74%) were conducted within Texas Oncology. Younger patients were significantly more likely to be tested than those diagnosed at older ages (p = 2.2e-16). Testing rates were significantly higher (p = 8.95e-07) at sites that employ a provider with genetics training; moreover, the rates of evaluation and testing trended upward, the longer those providers had been offering genetics services. Of the patients without test results, most (76%) had neither a genetics referral nor germline test order documented, suggesting an opportunity for provider education. Conclusions: Most patients who met criteria underwent genetic testing, but the rates varied by cancer type. Patients with breast cancer were most likely to have genetic testing. This study proved that having a genetics provider on staff significantly improved testing rates for patients who qualify. However, given that 100% of the cohort qualified and only 59% underwent testing, quality improvement measures are needed to increase the rate of genetic evaluations and testing for these diagnoses. [Table: see text]