title: Germline BRCA1/2 testing practices in ovarian cancer: Current state and opportunities for new directions.
abstract: OBJECTIVE
  Given the implications for clinical care and prevention in identifying a BRCA1/2 mutation, the objective of this study was to determine current BRCA1/2 testing practices in ovarian cancer and to identify future directions.
  
  
  METHODS
  Two parallel complementary web-based surveys were sent by email to representatives of Gynecologic Cancer InterGroup (GCIG) and to referral centers in countries with and without GCIG membership. Questions posed addressed indications of BRCA1/2 testing for ovarian cancer; the implication of genetic counseling; and prevention strategies employed.
  
  
  RESULTS
  Among the GCIG, 22 collaborative groups from 19 countries answered the survey. For the complementary survey, 22 referral centers replied. Findings show criteria to offer germline BRCA1/2 testing are mixed; 55% of GCIG members based testing decisions on histology and, among all respondents the main testing criterion remains family history. Typically, genetic counseling is scheduled prior to the genetic testing; however, if negative, results may not be communicated by the genetic counselor. Time between testing and communicating results varies widely between the groups. Lastly, recommendations to relatives regarding risk reduction surgery are inconsistent.
  
  
  CONCLUSIONS
  Our study highlights the need for collaborative efforts to devise international guidelines around BRCA1/2 testing in ovarian cancer to ensure consistent BRCA1/2 screening practices are adopted. Clinical practice is evolving rapidly and as BRCA1/2 testing is expected to become more widespread, new approaches are required. Coordinating BRCA1/2 testing practices is crucial in terms of care for the patient diagnosed with ovarian cancer but also towards cancer prevention for affected family members.
authors.affiliation: Division of Medical Oncology and Haematology, Bras Family Drug Development Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Lheureux
authors.affiliation: Division of Medical Oncology and Haematology, Bras Family Drug Development Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Karakasis
authors.affiliation: Kliniken-Essen-Mitte, AGO, Essen, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Harter
authors.affiliation: The Royal Melbourne Hospital, Parkville, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Scott
authors.affiliation: Gynecologic Cancer InterGroup (GCIG), Kingston, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Bacon
authors.affiliation: Clinical Trials Unit, MITO Istituto Nazionale dei Tumori - Fondazione G Pascale, Napoli, Italy.
authors.forename: J
authors.initials: J
authors.lastname: Bryce
authors.affiliation: Hôpital Hôtel-Dieu, Arcagy-GINECO, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Le Fur
authors.affiliation: Université Paris Descartes, AP-HP, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Pujade-Lauraine
authors.affiliation: Division of Medical Oncology and Haematology, Bras Family Drug Development Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Electronic address: amit.oza@uhn.ca.
authors.forename: A M
authors.initials: AM
authors.lastname: Oza
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003299:Cooperative Behavior; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling / Q000379:methods; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods* / Q000639:trends; D018095:Germ-Line Mutation; D017408:Guidelines as Topic; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000517:prevention & control; D011237:Predictive Value of Tests; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: BRCA1/2; Genetic counseling; Guidelines; Ovarian cancer; Testing