title: Keeping it simple: genetics referrals for all invasive serous ovarian cancers.
abstract: OBJECTIVE
  In the province of Ontario, all women diagnosed with invasive serous ovarian cancer are eligible for genetic testing for mutations in the BRCA1 and BRCA2 genes. This study aimed to determine the proportion of these women who are seen for genetic counseling and to identify potential predictors and barriers to having genetic counseling.
  
  
  METHODS
  All women who were diagnosed with invasive serous ovarian cancer and had genetic counseling at Princess Margaret Hospital (PMH) between 2002 and 2009 were identified. Logistic regressions and trend analyses explored age at diagnosis, year at diagnosis, and the time between diagnosis and genetic counseling. Genetic counseling outcomes were also examined.
  
  
  RESULTS
  Of 623 women diagnosed with invasive serous ovarian cancer, 144 (23%) were seen for genetic counseling. As age at diagnosis increased, the likelihood of genetic counseling decreased (p=0.005). With a more recent date of diagnosis, the probability of having genetic counseling increased (p=0.032) while the time to genetic counseling decreased (p=0.001). Of women who pursued genetic testing, 31% were found to have a BRCA1 or BRCA2 mutation, 16% of whom had no family history of breast or ovarian cancer.
  
  
  CONCLUSIONS
  Despite the availability of genetic testing, only a small proportion of women with invasive serous ovarian cancer were seen for genetic counseling. Over time, an improvement in the proportion of women being seen for genetic counseling was noted; however barriers to seeing women with a later age at diagnosis or those with no family history of breast or ovarian cancer clearly exist.
authors.affiliation: Division of Gynecologic Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada. Rochelle.Demsky@uhn.ca
authors.forename: R
authors.initials: R
authors.lastname: Demsky
authors.forename: J
authors.initials: J
authors.lastname: McCuaig
authors.forename: M
authors.initials: M
authors.lastname: Maganti
authors.forename: K J
authors.initials: KJ
authors.lastname: Murphy
authors.forename: B
authors.initials: B
authors.lastname: Rosen
authors.forename: S R
authors.initials: SR
authors.lastname: Armel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018284:Cystadenocarcinoma, Serous / Q000235:genetics*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics*; D012017:Referral and Consultation
keywords: BRCA1; BRCA2; Genetic counseling; Genetic testing; Ovarian cancer; Serous