title: Modes of delivery of genetic testing services and the uptake of cancer risk management strategies in BRCA1 and BRCA2 carriers.
abstract: BRCA testing services are now offered by various healthcare providers, thus it is important to evaluate whether the implementation of cancer risk management (CRM) strategies varies by service provider. Using a registry-based sample of 795 female BRCA mutation carriers, we explored the association between uptake of CRM strategies with duration of genetic counseling (GC) sessions, provider type, and other demographic and clinical variables. All participants completed a baseline questionnaire. Information about uptake of CRM strategies was collected for a subset of 438 participants who completed additional questions. Summary statistics and Pearson chi-squared analysis were used to examine the associations between demographic and clinical variables with service delivery factors and with the uptake of various CRM strategies. Overall uptake of CRM strategies was high across all provider types. However, GC sessions were longer when provided by a genetics professional than by another provider (p < 0.001). Furthermore, higher frequencies of uptake of most CRM strategies were associated with longer GC sessions and when testing was performed by a genetics professional. Identification of factors to optimize delivery of these specialized GC services is important to maximize implementation of CRM strategies in BRCA carriers.
authors: Division of Population Sciences, H. Lee Moffitt Cancer Center, Tampa, FL, USA.
authors: T
authors: T
authors: Pal
authors: J-H
authors: JH
authors: Lee
authors: A
authors: A
authors: Besharat
authors: Z
authors: Z
authors: Thompson
authors: A N A
authors: AN
authors: Monteiro
authors: C
authors: C
authors: Phelan
authors: J M
authors: JM
authors: Lancaster
authors: K
authors: K
authors: Metcalfe
authors: T A
authors: TA
authors: Sellers
authors: S
authors: S
authors: Vadaparampil
authors: S A
authors: SA
authors: Narod
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005820:Genetic Testing; D006579:Heterozygote; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000517:prevention & control; D009386:Neoplastic Syndromes, Hereditary / Q000175:diagnosis / Q000235:genetics; D011292:Premedication; D012042:Registries; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013629:Tamoxifen / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D013629:Tamoxifen
keywords: BRCA; clinical practice delivery; genetic counseling; genetic testing