A comparison of cancer risk assessment and testing outcomes in patients from underserved vs. tertiary care settings
In cancer genetics, technological advances (next generation sequencing) and the expansion of genetic test options have resulted in lowered costs and increased access to genetic testing. Despite this, the majority of patients utilizing cancer genetics services lack diversity of gender, ethnicity, and socioeconomic status. Through retrospective chart review, we compared outcomes of cancer genetics consultations at a tertiary cancer center and a Federally Qualified Health Center (FQHC) (58 tertiary and 23 FQHC patients) from 2013 to 2015. The two groups differed in race, ethnicity, use of translator services, and type of insurance coverage. There were also significant differences in completeness of family history information, with more missing information about relatives in the FQHC group. In spite of these differences, genetic testing rates among those offered testing were comparable across the two groups with 74% of tertiary patients and 60% of FQHC patients completing testing. Implementation of community-based cancer genetics outreach clinics represents an opportunity to improve access to genetic counseling services, but more research is needed to develop effective counseling models for diverse patient populations.
KeywordsCancer genetics Disparities Genetic counseling FQHC Underserved Interpreter BRCA
The authors would like to thank Carleen Gentry for her assistance with data collection, the management and staff of Whittier Street Health Center as well as the study participants for making this research possible.
The Dana-Farber Community Cancer Care Program is funded by a grant from the Kraft Family Research Fund.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Human studies and informed consent
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 (5). Institutional Review Board approval was obtained and the study was granted a waiver of informed consent for retrospective review of medical records.
No animal studies were carried out by the authors for this article.
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