Improving the Delivery of Genetic Services to Minnesota Women with Breast Cancer – North Memorial, Mercy and Unity Hospital Cancer Genetics Programs
Patients
that could benefit from cancer genetics services are often not identified and
referred. Most clinics collect family history, but do not
effectively triage patients to genetic services. Opportunities for cancer prevention and early
detection are being missed. Clinics need a systematic process of genetic triaging that can identify
these families, without burdening the clinic staff, physicians and patients.
We initiated
a pilot genetic triage project to 500 breast cancer patients in our cancer center. A patient-based, family
history collection tool was developed and given to patients. A family history diagram (pedigree) was drawn
from the completed form. A set of triage
criteria, a combination of published criteria, were applied to
these histories. Each history was assessed as Low, Moderate or High likelihood for
hereditary cancer risk. An assessment summary letter was then
sent to the patient's oncologist. Referred
patients were seen for genetic services and offered counseling and testing, if
appropriate.
This process
improved the identification of patients who could benefit from genetic
services. Evaluation of this project is not yet complete, but
about 25% of patients were identified as strong candidates for counseling, with a high likelihood
of hereditary cancer risk. The project
increased physician education regarding indications for referral. We have identified several patients who carry
cancer gene mutations through this project.
Appropriate genetic triage is complex. For this process to be clinically
sustainable, it must be automated.
For more information, contact: Barb Kunz
Phone:
763-520-3813
Email:
Barb.Kunz@NorthMemorial.com
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