Most patients with colorectal tumors at young age do not visit a cancer genetics clinic.
OBJECTIVE
This study examined the referral process for genetic counseling at a cancer genetics clinic in patients with colorectal cancer and to search for determinants of variation in this referral process.


METHODS
Patients who were recently diagnosed with colorectal cancer at a young age or multiple cancers associated with Lynch syndrome, hereditary nonpolyposis colorectal cancer, (N = 119) were selected from PALGA, the nationwide network and registry of histopathology and cytopathology in the Netherlands. In a retrospective analysis, we examined whether these patients visited a cancer genetics clinic and identified determinants for referral to such a clinic. Factors of patients, professional practice, and hospital setting were explored with logistic regression modeling.


RESULTS
Thirty-six (30 percent) patients visited a cancer genetics clinic. Seventy percent of patients whom the surgeon referred to a cancer genetics clinic decided to visit such a clinic. Analysis of determinants showed that patients with whom the surgeon discussed referral and that were treated in a teaching hospital were more likely to visit a cancer genetics clinic.


CONCLUSIONS
The referral process is not optimally carried out. To deliver optimal care for patients suspected of hereditary colorectal cancer, this process must be improved with interventions focusing on patient referral by surgeons and raising awareness in nonteaching hospitals.
Department of Human Genetics, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.
Lucia I H
LI
Overbeek
Nicoline
N
Hoogerbrugge
Joannes H J M
JH
van Krieken
Fokko M
FM
Nagengast
Theo J M
TJ
Ruers
Marjolijn J L
MJ
Ligtenberg
Rosella P M G
RP
Hermens
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D005817:Genetic Counseling / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011787:Quality of Health Care; D012017:Referral and Consultation; D012042:Registries; D012189:Retrospective Studies