Involving a genetic healthcare professional may improve quality, reduce unnecessary testing

A Moffitt Cancer Center (Tampa, FL) study published recently in Genetics in Medicine shows that counseling from a genetic healthcare provider before genetic testing educates patients and may help reduce unnecessary procedures.

Up to 10% of cancers are inherited, meaning a person is born with an abnormal gene that increases the risk for cancer. “Pre-test genetic counseling, in which a healthcare provider takes a thorough family history and discusses the potential risks and benefits of genetic testing, is standard of care as recommended by the American Society of Clinical Oncology and National Society of Genetic Counselors,” says Tuya Pal, MD, a board-certified geneticist at Moffitt and senior author of the paper.

Moffitt researchers surveyed 473 patients who had genetic testing for BRCA1 and BRCA2 gene mutations, which are associated with an increased risk of breast and ovarian cancers. Among study participants who saw a board-certified geneticist or genetic counselor, almost all recalled having a pre-test discussion, compared to only 59% of those who did not. These findings suggest large differences in quality of care across providers who order testing.

The researchers also suggest there may be cost-of-care implications when genetic healthcare providers are involved. “Our results suggest that genetic healthcare providers are less likely to order more expensive comprehensive genetic testing when less expensive testing may be appropriate,” says Deborah Cragun, PhD, lead study author. “Our study found that in cases where less expensive testing may be appropriate, genetic healthcare providers ordered comprehensive testing for 9.5% of participants, compared to 19.4% when tests were ordered by other healthcare providers.” The findings are important, researchers note, because costs and quality of care are often the focus of policy-level decisions in healthcare. Read the article preview.