Familial Cancer

, Volume 5, Issue 4, pp 297–303

Analysis of referrals to a multi-disciplinary breast cancer genetics clinic: practical and economic considerations

  • Marta M. Reis
  • Dorothy Young
  • Lorna McLeish
  • David Goudie
  • Alan Cook
  • Frank Sullivan
  • Helen Vysny
  • Alison Fordyce
  • Roger Black
  • Manouche Tavakoli
  • Michael Steel
Article

Abstract

Analysis of activity was undertaken in an established regional clinic providing risk assessment, counselling, screening and management for women with a family history of breast or ovarian cancer. The objectives were to determine: (1) how closely the route and pattern of referrals matched official guidelines (2) whether the previously recorded socio-economic imbalance among clinic clientele persisted and (3) the economic and practical consequences of committing resources to verification and extension of reported family histories. The findings were: (1) after some years of operation, the proportion of referrals direct from primary care had increased from less than 50% to over 75%, with a concomitant slight decrease in overall referral rate; (2) the socio-economic distribution of patients referred had become less selective and (3) extension and verification of reported family histories led to a redistributuion of risk categories, increasing the proportion of referrals judged to be in the “low risk” category, from 25% (based on referral letter alone) to 41% (at the end of the process). The costs associated with this approach are offset by the savings generated and it allows specialised counselling and screening services to be targeted more efficiently.

Keywords

Breast cancer Familial Genetic Clinical services Risk Assessment Economics Primary care 

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Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Marta M. Reis
    • 1
  • Dorothy Young
    • 1
  • Lorna McLeish
    • 1
  • David Goudie
    • 1
  • Alan Cook
    • 1
  • Frank Sullivan
    • 2
  • Helen Vysny
    • 1
    • 3
  • Alison Fordyce
    • 4
  • Roger Black
    • 4
  • Manouche Tavakoli
    • 5
  • Michael Steel
    • 1
    • 3
  1. 1.Tayside Breast Cancer Family ClinicNinewells Hospital and Medical SchoolDundeeUK
  2. 2.Community Health Sciences DivisionUniversity of Dundee Medical SchoolDundeeUK
  3. 3.Bute Medical SchoolUniversity of St AndrewsSt AndrewsUK
  4. 4.Information and Statistics Division (NHS Scotland)EdinburghUK
  5. 5.Department of ManagementUniversity of St AndrewsSt AndrewsUK

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