title: Oncologists' and cancer patients' views on whole-exome sequencing and incidental findings: results from the CanSeq study.
abstract: Although targeted sequencing improves outcomes for many cancer patients, it remains uncertain how somatic and germ-line whole-exome sequencing (WES) will integrate into care.
  
  
  
  We conducted surveys and interviews within a study of WES integration at an academic center to determine oncologists' attitudes about WES and to identify lung and colorectal cancer patients' preferences for learning WES findings.
  
  
  
  One-hundred sixty-seven patients (85% white, 58% female, mean age 60) and 27 oncologists (22% female) participated. Although oncologists had extensive experience ordering somatic tests (median 100/year), they had little experience ordering germ-line tests. Oncologists intended to disclose most WES results to patients but anticipated numerous challenges in using WES. Patients had moderately low levels of genetic knowledge (mean 4 correct out of 7). Most patients chose to learn results that could help select a clinical trial, pharmacogenetic and positive prognostic results, and results suggesting inherited predisposition to cancer and treatable noncancer conditions (all ≥95%). Fewer chose to receive negative prognostic results (84%) and results suggesting predisposition to untreatable noncancer conditions (85%).
  
  
  
  The majority of patients want most cancer-related and incidental WES results. Patients' low levels of genetic knowledge and oncologists' inexperience with large-scale sequencing present challenges to implementing paired WES in practice.Genet Med 18 10, 1011-1019.
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.|Harvard Medical School, Boston, Massachusetts, USA.|Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA.
authors: Stacy W
authors: 0000-0001-6948-0143
authors: SW
authors: Gray
authors: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: Elyse R
authors: ER
authors: Park
authors: Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
authors: Julie
authors: J
authors: Najita
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
authors: Yolanda
authors: Y
authors: Martins
authors: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: Lara
authors: L
authors: Traeger
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
authors: Elizabeth
authors: E
authors: Bair
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
authors: Joshua
authors: J
authors: Gagne
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.|Harvard Medical School, Boston, Massachusetts, USA.|Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA.
authors: Judy
authors: J
authors: Garber
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.|Harvard Medical School, Boston, Massachusetts, USA.|Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA.
authors: Pasi A
authors: PA
authors: Jänne
authors: Harvard Medical School, Boston, Massachusetts, USA.|Department of Pathology, Brigham & Woman's Hospital, Boston, Massachusetts, USA.
authors: Neal
authors: N
authors: Lindeman
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
authors: Carol
authors: C
authors: Lowenstein
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
authors: Nelly
authors: N
authors: Oliver
authors: Harvard Medical School, Boston, Massachusetts, USA.|Department of Pathology, Brigham & Woman's Hospital, Boston, Massachusetts, USA.
authors: Lynette
authors: L
authors: Sholl
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.|Harvard Medical School, Boston, Massachusetts, USA.|Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA.|Broad Institute, Cambridge, Massachusetts, USA.
authors: Eliezer M
authors: EM
authors: Van Allen
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.|Harvard Medical School, Boston, Massachusetts, USA.|Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA.|Broad Institute, Cambridge, Massachusetts, USA.
authors: Nikhil
authors: N
authors: Wagle
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
authors: Sam
authors: S
authors: Wood
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.|Harvard Medical School, Boston, Massachusetts, USA.|Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA.|Broad Institute, Cambridge, Massachusetts, USA.
authors: Levi
authors: L
authors: Garraway
authors: Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
authors: Steven
authors: S
authors: Joffe
mesh_terms: D000368:Aged; D059472:Exome / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D015894:Genome, Human; D018095:Germ-Line Mutation / Q000235:genetics*; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology; D000072103:Oncologists; D011379:Prognosis