title: Genetic Counselor Practices Involving Pediatric Patients with FAP: an Investigation of their Self-Reported Strategies for Genetic Testing and Hepatoblastoma Screening.
abstract: Familial adenomatous polyposis (FAP) is a cancer predisposition syndrome that causes early-onset polyposis and is associated with an increased risk for hepatoblastoma. There is currently a lack of consensus on when to order APC (adenomatous polyposis coli) gene testing or implement surveillance for hepatoblastoma. An online questionnaire was completed by 62 genetic counselors to capture their current practices regarding these questions. Extracolonic findings associated with FAP that were most likely to prompt APC testing in an otherwise asymptomatic 10 year-old child with a negative family history were multiple desmoid tumors, congenital hypertrophy of the retinal pigment epithelium (CHRPE), jaw osteomas, and hepatoblastoma. For hepatoblastoma screening, the majority did recommend this in children less than age five years with known APC mutations. An interval of every 3-6 months was most commonly suggested; however, responses extended to screening on a less than annual basis. These results highlight the need for further investigation into why some genetic counselors do not recommend APC testing in young at-risk children and what factors influence views about the ideal age and indication for APC testing. Studies of these issues would help to define the best clinical practice model for genetic testing and hepatoblastoma screening in pediatric patients with FAP.
authors.affiliation: Children's Mercy Hospital/University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. celawson@cmh.edu.
authors.forename: Caitlin E
authors.initials: CE
authors.lastname: Lawson
authors.affiliation: Children's Mercy Hospital/University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Attard
authors.affiliation: Children's Mercy Hospital/University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
authors.forename: Hongying
authors.initials: H
authors.lastname: Dai
authors.affiliation: Children's Hospital Colorado, Aurora, CO, USA.
authors.forename: Seth
authors.initials: S
authors.lastname: Septer
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D000072117:Counselors / Q000592:standards*; D005260:Female; D005817:Genetic Counseling / Q000379:methods* / Q000592:standards; D005820:Genetic Testing / Q000379:methods* / Q000592:standards; D018197:Hepatoblastoma / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000175:diagnosis*; D008297:Male; D057566:Self Report
keywords: Colon cancer; FAP; Hepatoblastoma; Pediatric genetic counseling