title: New paradigms for BRCA1/BRCA2 testing in women with ovarian cancer: results of the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study.
abstract: Over recent years genetic testing for germline mutations in BRCA1/BRCA2 has become more readily available because of technological advances and reducing costs.
  
  
  
  To explore the feasibility and acceptability of offering genetic testing to all women recently diagnosed with epithelial ovarian cancer (EOC).
  
  
  
  Between 1 July 2013 and 30 June 2015 women newly diagnosed with EOC were recruited through six sites in East Anglia, UK into the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study. Eligibility was irrespective of patient age and family history of cancer. The psychosocial arm of the study used self-report, psychometrically validated questionnaires (Depression Anxiety and Stress Scale (DASS-21); Impact of Event Scale (IES)) and cost analysis was performed.
  
  
  
  232 women were recruited and 18 mutations were detected (12 in BRCA1, 6 in BRCA2), giving a mutation yield of 8%, which increased to 12% in unselected women aged <70 years (17/146) but was only 1% in unselected women aged ≥70 years (1/86). IES and DASS-21 scores in response to genetic testing were significantly lower than equivalent scores in response to cancer diagnosis (p<0.001). Correlation tests indicated that although older age is a protective factor against any traumatic impacts of genetic testing, no significant correlation exists between age and distress outcomes.
  
  
  
  The mutation yield in unselected women diagnosed with EOC from a heterogeneous population with no founder mutations was 8% in all ages and 12% in women under 70. Unselected genetic testing in women with EOC was acceptable to patients and is potentially less resource-intensive than current standard practice.
authors.affiliation: Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridgeshire, UK East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.
authors.forename: Inga
authors.initials: I
authors.lastname: Plaskocinska
authors.affiliation: Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridgeshire, UK East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Shipman
authors.affiliation: East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.
authors.forename: James
authors.initials: J
authors.lastname: Drummond
authors.affiliation: East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Thompson
authors.affiliation: PHG Foundation, Cambridge, UK.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Buchanan
authors.affiliation: Cambridge Cancer Trials Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: Newcombe
authors.affiliation: Cambridge Cancer Trials Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hodgkin
authors.affiliation: Department of Oncology, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, Peterborough, UK.
authors.forename: Elisa
authors.initials: E
authors.lastname: Barter
authors.affiliation: Cancer Services, The Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Ridley
authors.affiliation: Cancer Services, The Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK.
authors.forename: Rita
authors.initials: R
authors.lastname: Ng
authors.affiliation: Clinical Cancer Services, Hinchingbrooke Health Care NHS Trust, Huntingdon, Cambridgeshire, UK.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Miller
authors.affiliation: Cancer Research Team, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK.
authors.forename: Adela
authors.initials: A
authors.lastname: Dann
authors.affiliation: Cancer Research Team, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Licence
authors.affiliation: Department of Oncology, The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK.
authors.forename: Hayley
authors.initials: H
authors.lastname: Webb
authors.affiliation: Clinical Cancer Services, Hinchingbrooke Health Care NHS Trust, Huntingdon, Cambridgeshire, UK.
authors.forename: Li Tee
authors.initials: LT
authors.lastname: Tan
authors.affiliation: Department of Oncology, The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Daly
authors.affiliation: Department of Oncology, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, Peterborough, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ayers
authors.affiliation: Cancer Services, The Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK.
authors.forename: Barnaby
authors.initials: B
authors.lastname: Rufford
authors.affiliation: Department of Oncology, University of Cambridge, NIHR Cambridge Biomedical Research Centre, Cambridge, Cambridgeshire, UK.
authors.forename: Helena
authors.initials: H
authors.lastname: Earl
authors.affiliation: Cancer Services, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Parkinson
authors.affiliation: Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Duncan
authors.affiliation: Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Jimenez-Linan
authors.affiliation: PHG Foundation, Cambridge, UK Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors.forename: Gurdeep S
authors.initials: GS
authors.lastname: Sagoo
authors.affiliation: Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridgeshire, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Abbs
authors.affiliation: Department of Psychology, University of Chester, Chester, Cheshire West and Chester, UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Hulbert-Williams
authors.affiliation: Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Pharoah
authors.affiliation: Cancer Services, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.
authors.forename: Robin
authors.initials: R
authors.lastname: Crawford
authors.affiliation: Cancer Services, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK Cancer Research UK Cambridge Institute, Cambridge, Cambridgeshire, UK.
authors.forename: James D
authors.initials: JD
authors.lastname: Brenton
authors.affiliation: Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridgeshire, UK East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK.
authors.forename: Marc
authors.initials: M
authors.lastname: Tischkowitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000191:economics*; D018095:Germ-Line Mutation; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000235:genetics*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000235:genetics*
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human
keywords: Clinical genetics; Genetic screening/counselling; Obstetrics and Gynaecology