Two case-finding strategies for women with a history of ovarian cancer for referral for genetic counseling and DNA testing (GCT) showed promise for general practitioners (GPs), according to a study published in the British Journal of General Practice.
A team of researchers from the Netherlands conducted a nonrandomized study to compare the efficacy of 2 pilot strategies targeted to find ovarian cancer survivors for GCT referral by their GPs.
The first strategy (strategy A) required GPs to determine and refer eligible patients with a history of ovarian cancer without the support of additional communication technology; the second strategy (strategy B) required GPs to identify patients electronically using information and communication technology (ICT). The percentages of patients who were contacted, referred by a GP for GCT, and seen by a clinical geneticist were used to measure the efficacy of each strategy. In addition, GP and patient questionnaires were used to assess the acceptance of each strategy.
Nineteen of 30 patients identified by strategy A and 39 of 94 identified by strategy B were eligible for GCT referral by GPs; 8 patients from each strategy were referred, and 5 were seen for GCT. Eleven of 36 patients approached GP practices for strategy A and 21 of 46 did for strategy B. Reasons for desirability of the strategies were “clinical relevance of case finding and referral,” “easy to perform,” “GP [was] the right person for case finding,” and “workability of the strategies”; these reasons were similar in both groups. Technical aspects of the strategies such as “too much work,” “ICT support should improve,” and “no ICT support required” were among the most common reasons for opposing desirability.
Of 15 patients who used the opportunity to report on desirability of case findings, 13 patients claimed case findings by the GP for referral for GCT were desirable predominantly because “knowing the increased risk is important for offspring.”
“The effectiveness and acceptance of both strategies for case finding of survivors of ovarian cancer in primary care for GCT is promising, but larger studies are required before wide-scale implementation is warranted,” the authors concluded.
Disclosure: This study was funded by AstraZeneca.
Helsper CW, Van Vliet LM, Velthuizen ME, et al. Identifying patients with a history of ovarian cancer for referral for genetic counseling: non-randomised comparison of two case-finding strategies in primary care. Br J Gen Pract. 2018; 68(676): e750-e756.