TY - JOUR
T1 - Exploring Stakeholders' Perspectives on Implementing Universal Germline Testing for Colorectal Cancer
T2 - Findings from a Clinical Practice Survey
AU - Rodgers-Fouche, Linda
AU - Arora, Sanjeevani
AU - Ricker, Charité
AU - Li, Dan
AU - Farooqi, Maheen
AU - Balaguer, Francesc
AU - Dominguez-Valentin, Mev
AU - Guillem, Jose G.
AU - Kanth, Priyanka
AU - Liska, David
AU - Melson, Joshua
AU - Mraz, Kathryn A.
AU - Shirts, Brian H.
AU - Vilar, Eduardo
AU - Katona, Bryson W.
AU - Hodan, Rachel
N1 - Publisher Copyright:
© 2023 by American Society of Clinical Oncology.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - PURPOSENew guidelines recommend considering germline genetic testing for all patients with colorectal cancer (CRC). However, there is a lack of data on stakeholders' perspectives on the advantages and barriers of implementing universal germline testing (UGT). This study assessed the perspectives of members of the Collaborative Group of the Americas on Inherited Gastrointestinal Cancer (CGA-IGC) regarding the implementation of UGT for patients with CRC, including readiness, logistics, and barriers.METHODSA cross-sectional survey was sent to 317 active members of CGA-IGC. The survey included sections on demographics, clinical practice specialty, established institutional practices for testing, and questions pertaining to support of and barriers to implementing UGT for patients with CRC.RESULTSEighty CGA-IGC members (25%) participated, including 42 genetic counselors (53%) and 14 gastroenterologists (18%). Forty-seven (59%) reported an academic medical center as their primary work setting, and most participants (56%) had more than 10 years of clinical practice. Although most participants (73%) supported UGT, 54% indicated that changes in practice would be required before adopting UGT, and 39% indicated that these changes would be challenging to implement. There was support for both genetics and nongenetics providers to order genetic testing, and a majority (57%) supported a standardized multigene panel rather than a customized gene panel. Key barriers to UGT implementation included limited genetics knowledge among nongenetics providers, time-consuming processes for obtaining consent, ordering tests, disclosing results, and lack of insurance coverage.CONCLUSIONThis study demonstrates wide support among hereditary GI cancer experts for implementation of UGT for patients with CRC. However, alternative service delivery models using nongenetics providers should be considered to address the logistical barriers to UGT implementation, particularly the growing demand for genetic testing.
AB - PURPOSENew guidelines recommend considering germline genetic testing for all patients with colorectal cancer (CRC). However, there is a lack of data on stakeholders' perspectives on the advantages and barriers of implementing universal germline testing (UGT). This study assessed the perspectives of members of the Collaborative Group of the Americas on Inherited Gastrointestinal Cancer (CGA-IGC) regarding the implementation of UGT for patients with CRC, including readiness, logistics, and barriers.METHODSA cross-sectional survey was sent to 317 active members of CGA-IGC. The survey included sections on demographics, clinical practice specialty, established institutional practices for testing, and questions pertaining to support of and barriers to implementing UGT for patients with CRC.RESULTSEighty CGA-IGC members (25%) participated, including 42 genetic counselors (53%) and 14 gastroenterologists (18%). Forty-seven (59%) reported an academic medical center as their primary work setting, and most participants (56%) had more than 10 years of clinical practice. Although most participants (73%) supported UGT, 54% indicated that changes in practice would be required before adopting UGT, and 39% indicated that these changes would be challenging to implement. There was support for both genetics and nongenetics providers to order genetic testing, and a majority (57%) supported a standardized multigene panel rather than a customized gene panel. Key barriers to UGT implementation included limited genetics knowledge among nongenetics providers, time-consuming processes for obtaining consent, ordering tests, disclosing results, and lack of insurance coverage.CONCLUSIONThis study demonstrates wide support among hereditary GI cancer experts for implementation of UGT for patients with CRC. However, alternative service delivery models using nongenetics providers should be considered to address the logistical barriers to UGT implementation, particularly the growing demand for genetic testing.
UR - https://www.scopus.com/pages/publications/85207360208
UR - https://www.scopus.com/pages/publications/85207360208#tab=citedBy
U2 - 10.1200/PO.23.00440
DO - 10.1200/PO.23.00440
M3 - Article
C2 - 37897815
AN - SCOPUS:85207360208
SN - 2473-4284
VL - 7
JO - JCO Precision Oncology
JF - JCO Precision Oncology
M1 - e2300440
ER -
