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Oncologists’ perspectives of telephone genetic counseling to facilitate germline BRCA1/2 testing for their patients with high-grade serous ovarian cancer

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Abstract

Poly ADP ribose polymerase (PARP) inhibitors offer a survival advantage to women with high-grade serous ovarian cancer who have a germline BRCA1/2 pathogenic variant (PV). Yet, rates of genetic testing among this population have remained persistently low. A national, centralized telephone genetic counseling service was established in January 2016 in Australia to improve access to genetic services and facilitate BRCA1/2 testing for this population to inform treatment. Medical oncologists can refer their patients with high-grade serous ovarian cancer to this service for genetic testing. This study aimed to explore oncologists’ experiences of using this telephone genetic counseling service for their patients with high-grade serous ovarian cancer. A qualitative approach using semi-structured telephone interviews was undertaken with Australian oncologists who had referred patients to the telephone genetic counseling service. Sixteen oncologists participated and described referring patients to the telephone genetic counseling service due to the timeliness of obtaining a genetic counseling appointment and BRCA1/2 test results. They also reported this service offered convenience for patients living in regional or rural areas who then did not have to travel for an appointment with a clinical genetics service. Many oncologists noted the importance of in-person genetic counseling for patients who received positive BRCA1/2 results. Areas for improvement identified by the oncologists related to communication issues between the service and the patient. Overall, findings suggest that oncologists perceived telephone genetic counseling as an acceptable and useful healthcare service for patients with high-grade serous ovarian cancer. Moreover, they perceived telephone genetic counseling to be efficient, delivering convenient genetic counseling to patients.

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Acknowledgements

We would like to thank all the oncologists who participated in this study. The evaluation of the telephone genetic counseling service is funded by a National Health and Medical Research Council (NHMRC) program grant (PI: A/Prof Paul James). Bettina Meiser was supported by a Senior Research Fellowship Level B from the National Health and Medical Research Council of Australia (ID 1078523). Laura Forrest is supported by a postdoctoral fellowship from the National Breast Cancer Foundation (14-009). This paper was completed as part of the Independent Learning Project by Pierre Hemming which contributed towards his medical degree at the University of New South Wales.

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Authors and Affiliations

  1. Psychosocial Research Group, Prince of Wales Clinical School, UNSW, Sydney, Australia

    Pierre Hemming, Rajneesh Kaur & Bettina Meiser

  2. UNSW Medicine, UNSW, Sydney, Australia

    Pierre Hemming

  3. Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, 3000, Australia

    Joanne McKinley, Paul A. James & Laura E. Forrest

  4. Garvan Institute of Medical Research, Sydney, Australia

    Mary-Anne Young

  5. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia

    Paul A. James & Laura E. Forrest

Authors
  1. Pierre Hemming
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  2. Rajneesh Kaur
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  3. Bettina Meiser
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  4. Joanne McKinley
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  5. Mary-Anne Young
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  6. Paul A. James
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  7. Laura E. Forrest
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Corresponding author

Correspondence to Laura E. Forrest.

Ethics declarations

This study was approved by the Peter MacCallum Human Research Ethics Committee, Victoria, Australia (protocol no. 17/16). Verbal consent was obtained prior to audio-recording each interview. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Conflict of interest

Paul James is the director of the Parkville Familial Cancer Centre at the Peter MacCallum Cancer Centre that received funding from AstraZeneca for the Telephone Genetic Counseling Service. Bettina Meiser has a remunerated consultant role with the company AstraZeneca with respect to an unrelated project. Laura Forrest, Joanne McKinley, Rajneesh Kaur, Mary-Anne Young, and Pierre Hemming declare that they have no conflict of interest.

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Hemming, P., Kaur, R., Meiser, B. et al. Oncologists’ perspectives of telephone genetic counseling to facilitate germline BRCA1/2 testing for their patients with high-grade serous ovarian cancer. J Community Genet 12, 449–457 (2021). https://doi.org/10.1007/s12687-021-00530-7

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  • DOI: https://doi.org/10.1007/s12687-021-00530-7

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