Description
Fewer than 15% of women at risk for Hereditary Breast and Ovarian Cancer Syndrome (HBOC) are referred for genetic testing; less among women from racial/ethnic minorities. We developed the RealRisks Patient Decision Aid and BNAV Provider Decision Support to simultaneously address patient and provider barriers to expanding genetic testing for HBOC. Methods: Eighty providers enrolled in a trial completed a baseline survey to assess preparedness for implementing genetic testing. The Theory of Planned Behavior (TPB) assessed predictors of genetic testing intention. Results: Providers were moderately confident in managing patients with a family history of breast/ovarian cancer. About one third reported ever using breast cancer risk assessment tools. All TPB variables significantly predicted intention to make genetic testing referrals. Discussion: Efforts to expand genetic testing should help providers identify patients and foster confidence to manage patients with a history of breast/ovarian cancer. Findings confirm the need for decision support tools like those we are currently evaluating in a clinical trial.
Learning Objective: 1. Understand the current issues in underutilization of genetic testing services for Hereditary Breast and Ovarian Syndrome (HBOC), including lack of identification of at risk patients particularly in minority populations, and be able to discuss and recommend the use of decision support to address the factors than can contribute to low uptake.
2. Learn challenges and possible solutions in providing decision support tools that address patient and provider-barriers to implementing genetic testing in primary care settings that serve minority patients.
3. Formulate an approach to address implementation gaps in precision medicine guided cancer genetic risk assessment and prevention in primary care settings.
Authors:
Rita Kukafka (Presenter)
Columbia University
Margaret Sin, Columbia University
Thomas Silverman, Columbia University
Katherine Crew, Columbia University
Presentation Materials: