Original Article

International Journal of Clinical Oncology

, Volume 19, Issue 6, pp 1043-1051

Development of an integrated support system for hereditary cancer and its impact on gynecologic services

  • Mina Morii-KashimaAffiliated withDepartment of Obstetrics and Gynecology, Hyogo College of Medicine
  • , Hiroshi TsubamotoAffiliated withDepartment of Obstetrics and Gynecology, Hyogo College of Medicine Email author 
  • , Chika SatoAffiliated withDepartment of Genetics, Hyogo College of Medicine
  • , Mariko UshiodaAffiliated withDepartment of Obstetrics and Gynecology, Hyogo College of Medicine
  • , Naohiro TomitaAffiliated withDivision of Lower GI, Department of Lower Gastrointestinal Surgery, Hyogo College of Medicine
  • , Yasuo MiyoshiAffiliated withDepartment of Breast and Endocrine Surgery, Hyogo College of Medicine
  • , Tomoko Hashimoto-TamaokiAffiliated withDepartment of Genetics, Hyogo College of Medicine
  • , Kazuo TamuraAffiliated withDivision of Lower GI, Department of Lower Gastrointestinal Surgery, Hyogo College of MedicineDepartment of Life Science, Faculty of Science and Engineering, Kinki University
  • , Hideaki SawaiAffiliated withDepartment of Obstetrics and Gynecology, Hyogo College of Medicine
    • , Hiroaki ShibaharaAffiliated withDepartment of Obstetrics and Gynecology, Hyogo College of Medicine

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Abstract

Objective

Patients with hereditary cancer need an integrated support system. A recently launched project was evaluated in terms of its efficacy in screening patients with hereditary cancer at the gynecologic service.

Methods

The project team comprised gynecologists, surgeons, medical geneticists, and certified genetic counselors (CGCs) in our hospital. At the gynecologic service, a newly developed self-administered family history questionnaire (SAFHQ) was given to patients with ovarian, endometrial, or breast cancer as well as a history of multiple cancers. After an interview, a CGC constructed a pedigree and evaluated the risk for hereditary cancer. Patients at risk were recommended by a gynecologist to receive further genetic counseling at the Department of Genetics according to the modified Bethesda criteria, Amsterdam II criteria, and National Comprehensive Cancer Network (NCCN) guidelines 2012 for breast–ovarian cancer syndrome (HBOC). The numbers of newly screened patients were compared before and after the project launch.

Results

The SAFHQ was administered to 131 patients and 106 (81 %) pedigrees were constructed between August 2012 and July 2013. The number of newly screened patients according to the Bethesda criteria was 4 and 8 at 10 years before and 1 year after the project launch, respectively. Two and 31 patients met the NCCN criteria for HBOC excluding ovarian cancer alone, respectively, at these 2 time points. Of 54 patients who were recommended to undergo further counseling, 10 (19 %) visited the Department of Genetics.

Conclusion

After the launch of an integrated support system, the number of patients with hereditary cancers who were screened increased. The gynecologic service played a pivotal role in patient and family care.

Keywords

Gynecology Lynch syndrome Hereditary breast and ovarian cancer Genetic counseling PDSA cycle