title: Pre-test genetic counseling services for hereditary breast and ovarian cancer delivered by non-genetics professionals in the state of Florida.
abstract: Genetic counseling and testing for hereditary breast and ovarian cancer now includes practitioners from multiple healthcare professions, specialties, and settings. This study examined whether non-genetics professionals (NGPs) perform guideline-based patient intake and informed consent before genetic testing. NGPs offering BRCA testing services in Florida (n = 386) were surveyed about clinical practices. Among 81 respondents (response rate = 22%), approximately half reported: sometimes scheduling a separate session for pre-test counseling lasting 11-30 min prior to testing, discussing familial implications of testing, benefits and limitations of risk management options, and discussing the potential psychological impact and insurance-related issues. Few constructed a three-generation pedigree, discussed alternative hereditary cancer syndromes, or the meaning of a variant result. This lack of adherence to guideline-based practice may result in direct harm to patients and their family members. NGPs who are unable to deliver guideline adherent cancer genetics services should focus on identification and referral of at-risk patients to in person or telephone services provided by genetics professionals.
authors.affiliation: Division of Population Sciences, H. Lee Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: S T
authors.initials: ST
authors.lastname: Vadaparampil
authors.forename: C L
authors.initials: CL
authors.lastname: Scherr
authors.forename: D
authors.initials: D
authors.lastname: Cragun
authors.forename: T L
authors.initials: TL
authors.lastname: Malo
authors.forename: T
authors.initials: T
authors.lastname: Pal
mesh_terms: D019313:BRCA1 Protein / Q000235:genetics; D024682:BRCA2 Protein / Q000235:genetics; D005260:Female; D005431:Florida / Q000453:epidemiology; D005817:Genetic Counseling; D005820:Genetic Testing; D006282:Health Personnel; D061325:Hereditary Breast and Ovarian Cancer Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*; D006801:Humans; D008297:Male; D011361:Professional Competence
chemical_list: D019313:BRCA1 Protein; D024682:BRCA2 Protein
keywords: BRCA; genetic counseling; genetic testing; hereditary breast and ovarian cancer; non-genetics professionals
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