Despite ACOG recommendations, many Obstetricians and Gynecologists (Ob/Gyns) do not routinely screen patients for hereditary cancer risk. Here we evaluate the feasibility of improving screening, genetic risk assessment, and testing services in community Ob/Gyn practices.
This was a prospective, single arm process intervention study at two community Ob/Gyn office sites. Data was collected during a 8 weeks pre-intervention and 8-week post-intervention period. There was a 4-week practice period following process intervention. Surveys were completed by providers and patients who underwent genetic testing.
During the pre-intervention period, 3,882 patients were seen and 43 (1.1%) had genetic testing for hereditary cancer risk. In the post-intervention period, 4,107 patients were seen and genetic testing was ordered for 219 (5.3%) patients. Of those who completed genetic testing, 5.5% (9/165) were found to carry a pathogenic variant. Regarding their experience with screening and genetic testing, 98.8% (167/169) of patients were able to understand the information provided and 97.6% (165/169) were satisfied with the overall process. All providers (15/15) reported that they would continue to use this process to screen and test patients at risk for hereditary cancer and 93.3% (14/15) were satisfied with the process implementation.
This process intervention resulted in a substantial improvement in the proportion of at-risk patients who had genetic testing, with patients and providers reporting a positive experience. This demonstrates that Ob/Gyns are capable of counseling and ordering hereditary cancer genetic testing and that integration into routine practice is feasible and beneficial in a community Ob/Gyn setting.