Online screening tool, genetic education improve gynecologic cancer risk assessment

Key takeaways:

• Digital screening improved identification of patients meeting hereditary risk assessment guidelines.
• Patient education improved genetic testing and the ability to delivery hereditary cancer risk assessment.

Incorporating digital screening tools and patient education into obstetrics and gynecology care may improve hereditary cancer risk assessment and genetic testing completion, according to study results published in Obstetrics & Gynecology.

“In a recent study, integration of refined, protocol-driven, clinic-specific hereditary cancer risk assessment processes resulted in a fourfold increase in genetic testing among patients in two U.S. community obstetrics and gynecology practices, which enabled detection of pathogenic variants that would not otherwise have been identified and helped clinicians better meet standard of care,” Richard N. Waldman, MD, president of the medical staff at St. Joseph’s Hospital Health Center, and colleagues wrote. “The study also highlighted a need to improve patients’ genetic literacy.”

Waldman and colleagues analyzed data from five U.S. OB/GYN practices where clinicians received 3 to 4 weeks of training on online patient screening and virtual patient education consisting of prerecorded video with or without a genetic counselor phone call for genetic testing-eligible patients. After a 4-week practice period, researchers collected hereditary cancer risk assessment and patient education metrics (n = 5,135) and compared results with preintervention metrics (n = 5,795).

Primary outcome was change in genetic testing completion rates.

Researchers observed an increase in the proportion of screened patients meeting testing guidelines after the intervention was implemented (21.6% vs. 28.2%; OR = 1.36; 95% CI, 1.26-1.47; P < .001). Guideline-eligible patients were more likely to be offered genetic testing (59.1% vs. 89.1%; OR = 2.06; 95% CI, 1.87-2.27; P < .001), to submit samples (32.9% vs. 45%; OR = 1.49; 95% CI, 1.27-1.74; P < .001) and to complete genetic testing (16% vs. 34.2%; OR = 2.38; 95% CI, 2-2.83; P < .001), the researchers wrote.

Most clinicians agreed or strongly agreed that the digital screening tool improved identification of patients meeting hereditary cancer risk assessment guidelines (92.1%), saved time (64.9%) and was easy to incorporate in OB/GYN care (68.4%). In addition, most clinicians agreed or strongly agreed that patient education improved the ability to delivery hereditary cancer risk assessment standard of care (84.2%).

Among patients, 91.7% agreed or strongly agreed that virtual education helped to understand the purpose of genetic testing and 92.6% agreed or strongly agreed that virtual education helped to understand genetic testing implications.

“These findings have compelling population-wide implications for improved comprehensive health care by increasing opportunities for risk-reducing medical intervention and early cancer detection and treatment, as well as appreciable potential to improve women’s health outcomes, to prevent cancer deaths and to alleviate some of the national economic burden of cancer prevention and care,” the researchers wrote.