title: Timing of referral for genetic counseling and genetic testing in patients with ovarian, fallopian tube, or primary peritoneal carcinoma.
abstract: OBJECTIVE
  The objective of this study was to assess patients' preferences of the timing of referral for genetic counseling and testing in relation to the diagnosis, treatment, and recurrence of ovarian, tubal, or primary peritoneal cancers.
  
  
  METHODS
  Ninety-two patients who underwent counseling and testing by 1 certified genetic counselor were identified. An introductory letter, consent form, and questionnaire were mailed to gather information regarding factors influencing the decision to undergo genetic counseling and testing and opinions regarding optimal timing. Medical records were reviewed for demographic and clinical data.
  
  
  RESULTS
  Of 47 consenting women, 45 underwent testing. Eight (18%) were found to have a genetic mutation. Women lacked consensus about the optimal time for referral for and to undergo genetic testing, although women with stage I disease preferred testing after completion of chemotherapy. Most women were comfortable receiving the results by phone, but one third preferred an office visit.
  
  
  CONCLUSIONS
  Patients' views regarding the best time to be referred for and undergo counseling and testing varied greatly. Because of the high mortality of this disease, clinicians should discuss referral early and personalize the timing to each patient. The subset of patients who prefer results disclosure during an office visit should be identified at the time of their initial counseling.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine and Siteman Cancer Center, St Louis, MO, USA. novetskya@wudosis.wustl.edu
authors.forename: Akiva P
authors.initials: AP
authors.lastname: Novetsky
authors.forename: Kylie
authors.initials: K
authors.lastname: Smith
authors.forename: Sheri A
authors.initials: SA
authors.lastname: Babb
authors.forename: Donna B
authors.initials: DB
authors.lastname: Jeffe
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Hagemann
authors.forename: Premal H
authors.initials: PH
authors.lastname: Thaker
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Powell
authors.forename: David G
authors.initials: DG
authors.lastname: Mutch
authors.forename: L Stewart
authors.initials: LS
authors.lastname: Massad
authors.forename: Israel
authors.initials: I
authors.lastname: Zighelboim
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D000368:Aged; D019313:BRCA1 Protein / Q000235:genetics; D024682:BRCA2 Protein / Q000235:genetics; D018284:Cystadenocarcinoma, Serous / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D005185:Fallopian Tube Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005817:Genetic Counseling / Q000523:psychology*; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D011379:Prognosis; D012017:Referral and Consultation; D015996:Survival Rate; D013997:Time Factors
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human