Premium
A feasibility study of breast cancer genetic risk assessment in a federally qualified health center
Author(s) -
Hoskins Kent F.,
Tejeda Silvia,
Vijayasiri Ganga,
Chukwudozie Ifeanyi Beverly,
Remo Mylene H.,
Shah Hiral A.,
Abraham Ivy E.,
Balay Lara E.,
Maga Tara K.,
Searles Ericka R.,
Korah Veena J.,
Biggers Alana,
Stolley Melinda R.,
Warnecke Richard B.
Publication year - 2018
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.31635
Subject(s) - medicine , family medicine , referral , disadvantaged , breast cancer , health care , intervention (counseling) , breast cancer screening , cancer , nursing , mammography , political science , law , economics , economic growth
BACKGROUND The US Preventive Services Task Force (USPSTF) endorses routine screening for genetic risk of breast and/or ovarian cancer as a component of primary health care. Implementation of this recommendation may prove challenging, especially in clinics serving disadvantaged communities. METHODS The authors tested the feasibility of implementing the USPSTF mandate at a federally qualified health center (FQHC) to identify women who were eligible for genetic counseling (GC). A 12‐month usual‐care phase was followed by a 12‐month intervention phase, during which time cancer genetic risk assessment (CGRA) was systematically performed for all women aged 25 to 69 years who presented for an annual examination. Women who were eligible for GC were recruited to participate in the study. RESULTS After initiating CGRA, 112 women who were eligible for GC consented to study participation, and 56% of them received a referral for GC from their primary care physician. A subgroup of 50 participants were seen by the same primary care physician during both the usual‐care and intervention phases. None of these patients was referred for GC during usual care, compared with 64% after the initiation of CGRA ( P < .001). Only 16% of referred participants attended a GC session. CONCLUSIONS Implementing USPSTF recommendations for CGRA as a standard component of primary health care in FQHCs is feasible and improves referral of minority women for GC, but more work is needed to understand the beliefs and barriers that prevent many underserved women from accessing cancer genetic services.