title: Development of an integrated support system for hereditary cancer and its impact on gynecologic services.
abstract: OBJECTIVE
  Patients with hereditary cancer need an integrated support system. A recently launched project was evaluated in terms of its efficacy in screening patients with hereditary cancer at the gynecologic service.
  
  
  METHODS
  The project team comprised gynecologists, surgeons, medical geneticists, and certified genetic counselors (CGCs) in our hospital. At the gynecologic service, a newly developed self-administered family history questionnaire (SAFHQ) was given to patients with ovarian, endometrial, or breast cancer as well as a history of multiple cancers. After an interview, a CGC constructed a pedigree and evaluated the risk for hereditary cancer. Patients at risk were recommended by a gynecologist to receive further genetic counseling at the Department of Genetics according to the modified Bethesda criteria, Amsterdam II criteria, and National Comprehensive Cancer Network (NCCN) guidelines 2012 for breast-ovarian cancer syndrome (HBOC). The numbers of newly screened patients were compared before and after the project launch.
  
  
  RESULTS
  The SAFHQ was administered to 131 patients and 106 (81 %) pedigrees were constructed between August 2012 and July 2013. The number of newly screened patients according to the Bethesda criteria was 4 and 8 at 10 years before and 1 year after the project launch, respectively. Two and 31 patients met the NCCN criteria for HBOC excluding ovarian cancer alone, respectively, at these 2 time points. Of 54 patients who were recommended to undergo further counseling, 10 (19 %) visited the Department of Genetics.
  
  
  CONCLUSIONS
  After the launch of an integrated support system, the number of patients with hereditary cancers who were screened increased. The gynecologic service played a pivotal role in patient and family care.
authors.affiliation: Department of Obstetrics and Gynecology, Hyogo College of Medicine, Mukogawa 1-1, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Mina
authors.initials: M
authors.lastname: Morii-Kashima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsubamoto
authors.forename: Chika
authors.initials: C
authors.lastname: Sato
authors.forename: Mariko
authors.initials: M
authors.lastname: Ushioda
authors.forename: Naohiro
authors.initials: N
authors.lastname: Tomita
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Miyoshi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hashimoto-Tamaoki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tamura
authors.forename: Hideaki
authors.initials: H
authors.lastname: Sawai
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shibahara
mesh_terms: D005817:Genetic Counseling / Q000379:methods; D006176:Gynecology / Q000379:methods; D006801:Humans; D008403:Mass Screening / Q000379:methods; D009369:Neoplasms / Q000175:diagnosis*; D005791:Patient Care / Q000379:methods; D012306:Risk; D011795:Surveys and Questionnaires