Factors associated with referral and completion of genetic counseling in women with epithelial ovarian cancer

ObjectiveThe National Comprehensive Cancer Network recommends that all women diagnosed with epithelial ovarian cancer undergo genetic testing, as the diagnosis of pathogenic variants may inform cancer survival and impact treatment options. The objective of this study was to assess factors associated with referral to genetic counseling in women with epithelial ovarian cancer.MethodsA retrospective cohort study identified women with epithelial ovarian cancer from 2012 to 2017 at Massachusetts General Hospital and North Shore Medical Center, a community hospital affiliated with Massachusetts General Hospital. Multivariate logistic regression evaluated how race, age, stage, year of diagnosis, insurance status, family history of breast or ovarian cancer, and language relates to the receipt of genetic counseling.ResultsOf the total 276 women included, 73.9% were referred for genetic screening, of which 90.7% attended a genetic counseling visit. Older women were less likely to undergo genetic counseling (age ≥70 years: OR 0.26, 95% CI 0.07–0.94, p=0.04). Women who died within 365 days of initial oncology consult rarely reached a genetic counselor (OR 0.05, 95% CI 0.01–0.24, p<0.001). Women with a family history of breast or ovarian cancer were more likely to undergo counseling (OR 3.27, 95% CI 1.74–6.15, p<0.001). There was no difference in receipt of genetic counseling by race, stage, year of diagnosis, insurance status, or language.ConclusionOlder women with epithelial ovarian cancer and those who died within 1 year of initiation of care were less likely to undergo recommended genetic counseling. Race, insurance status, and language were not identified as predictive factors, although we were limited in this assessment by small sample size.

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Internet use is associated with utilization of genetic counseling for BRCA 1/2 mutations in women with a family history of breast or ovarian cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.10654 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 10654-10654 ◽

Cited By ~ 1

Author(s):

K. Armstrong ◽

S. Gray ◽

S. Domchek

Keyword(s):

Ovarian Cancer ◽

Genetic Counseling ◽

Family History ◽

Cancer Risk ◽

Health Information ◽

Internet Use ◽

The Internet ◽

Frequent Use ◽

Brca 1 ◽

History Of

10654 Background: Women obtain breast cancer risk information from a variety of sources including mass media, the internet and personal and professional sources. Little is know about how internet use for health information influences choices about breast cancer risk evaluation and decision making. Methods: Case control study of 408 women with a family history of breast or ovarian cancer, of whom 217 underwent genetic counseling for BRCA 1/2 testing (cases) and 191 women who did not (controls). Participants received primary care within a large health system in greater Philadelphia, PA. Results: Women with a family history of breast or ovarian cancer who reported frequent use of the internet for health information (>1–2 times a month) were significantly more likely to undergo genetic counseling for BRCA 1/2 testing than women that rarely used the internet to obtain health information (<2 times a year) (odds ratio 2.6; 95% CI 1.7–4.0). This association persisted after adjustment for age, race, education and Gail risk (adjusted odds ratio 2.1; 95% CI 1.05–4.2) Conclusions: Frequent use of the internet for health care information is associated with higher use of genetic counseling for BRCA 1/2 mutations in women with a family history of breast or ovarian cancer. The association can not be explained by differences in education, cancer risk, age or race. A possible hypothesis for this association is that internet use exposes women to more information about genetic testing, BRCA testing opportunities and the experiences of other women who have utilized BRCA counseling services. No significant financial relationships to disclose.

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Factors associated with the incompliance with mammogram screening among individuals with a family history of breast cancer or ovarian cancer

Breast Cancer Research and Treatment ◽

10.1007/s10549-006-9298-5 ◽

2006 ◽

Vol 101 (3) ◽

pp. 317-324 ◽

Cited By ~ 10

Author(s):

Hongyu Wu ◽

Kangmin Zhu ◽

Ismail Jatoi ◽

Mona Shah ◽

Craig D. Shriver ◽

...

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

Family History ◽

Factors Associated ◽

History Of

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Predictors of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ (DCIS) who underwent evaluation for BRCA genetic testing.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.1549 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 1549-1549

Author(s):

Nisreen Elsayegh ◽

Angelica M. Gutierrez-Barrera ◽

Kimberly I. Muse ◽

Heather Lin ◽

Diana L. Turco ◽

...

Keyword(s):

Breast Cancer ◽

Genetic Counseling ◽

Family History ◽

Tumor Markers ◽

Prophylactic Mastectomy ◽

Contralateral Prophylactic Mastectomy ◽

Educational Status ◽

Nuclear Grade ◽

Factors Associated ◽

History Of

1549 Background: Patients with DCIS are at increased risk for developing contralateral breast cancer (CBC). Therefore, an increasing number of women with DCIS are electing for contralateral prophylactic mastectomy (CPM). In a previous study involving 2072 women with DCIS, 13.5% chose CPM. In this study, we aimed to evaluate factors associated with CPM in patients with DCIS who underwent genetic counseling for BRCA. Methods: 165 women with pure DCIS, who underwent genetic counseling, were included in the study. Patients’ characteristics were obtained from a prospectively maintained research database at UT M.D. Anderson Cancer Center. Univariate and multivaraite logistic regression analysis were used to determine predictive factors associated with CPM. Patients’ characteristics included age, marital and educational status, tumor markers, nuclear grade, family history with breast (BC) and ovarian cancer (OC), race, Ashkenazi Jewish ancestry, and BRCA genetic test results. Results: Out of 165 patients, 17(10.3%) were found to have a BRCA deleterious mutation. 44(26.7%) underwent CPM. Younger patients (median ≤ 45 yr) were more likely to elect for CPM than older patients (p= 0.0098). Patients who tested positive for a BRCA mutation were more likely to elect for CPM than those who tested negative or were not tested (p= 0.0001). Patients who had a family history of OC (15 (57.7%) were more likely to choose CPM than those who did not (p= 0.0004). These three factors remained significant in the multivariate model (p <0.008). Marital and educational status, tumor markers, nuclear grade, and family history of breast cancer were not significant predictors of CPM. Conclusions: The rate of CPM in patients with DCIS is high. Factors associated with increased likelihood of undergoing CPM include family history of OC, age, and BRCA positivity. Further studies are needed to evaluate patients perception of CBC risk, and if this may play a role in the high number of CPM.

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Incidence and mortality in epithelial ovarian cancer by family history of any cancer

Cancer ◽

10.1002/cncr.26016 ◽

2011 ◽

Vol 117 (17) ◽

pp. 3972-3980 ◽

Cited By ~ 10

Author(s):

Kari Hemminki ◽

Jan Sundquist ◽

Andreas Brandt

Keyword(s):

Ovarian Cancer ◽

Family History ◽

Epithelial Ovarian Cancer ◽

Incidence And Mortality ◽

History Of

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Prevalence of germline pathogenic BRCA1/2 variants in sequential epithelial ovarian cancer cases

Journal of Medical Genetics ◽

10.1136/jmedgenet-2018-105792 ◽

2019 ◽

Vol 56 (5) ◽

pp. 301-307 ◽

Cited By ~ 7

Author(s):

Robert D Morgan ◽

George J Burghel ◽

Nicola Flaum ◽

Michael Bulman ◽

Andrew R Clamp ◽

...

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

Family History ◽

Epithelial Ovarian Cancer ◽

Medical History ◽

Progression Free Survival ◽

Cancer Syndrome ◽

Platinum Sensitive ◽

Endometrioid Ovarian Carcinoma ◽

History Of

IntroductionPoly(ADP-ribose) polymerase inhibitors significantly improve progression-free survival in platinum-sensitive high-grade serous and endometrioid ovarian carcinoma, with greatest benefits observed in women with a pathogenic BRCA1/2 variant. Consequently, the demand for germline BRCA1/2 testing in ovarian cancer has increased substantially, leading to the screening of unselected populations of patients. We aimed to determine the prevalence of pathogenic germline BRCA1/2 variants in women diagnosed with epithelial ovarian cancer, categorised according to the established risk factors for hereditary breast and ovarian cancer syndrome and the Manchester BRCA Score, to inform risk stratification.MethodsA cohort of sequential epithelial ovarian cancer cases recruited between June 2013 and September 2018 underwent germline BRCA1/2 testing by next-generation sequencing and multiplex ligation-dependent probe amplification.ResultsFive hundred and fifty-seven patients were screened. Of these, 18% had inherited a pathogenic BRCA1/2 variant. The prevalence of pathogenic BRCA1/2 variants was >10% in women diagnosed with ovarian cancer earlier than 60 years of age (21%) and those diagnosed later than 60 years of age with a family history of breast and/or ovarian cancer (17%) or a medical history of breast cancer (34%). The prevalence of pathogenic BRCA1/2 variants was also >10% in women with a Manchester BRCA Score of ≥15 points (14%).DiscussionOur study suggests that age at diagnosis, family history of breast and/or ovarian cancer, medical history of breast cancer or a Manchester BRCA Score of ≥15 points are associated with a >10% prevalence of germline pathogenic BRCA1/2 variants in epithelial ovarian cancer.

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EPITHELIAL OVARIAN CANCER;

The Professional Medical Journal ◽

10.29309/tpmj/2012.19.01.1932 ◽

2012 ◽

Vol 19 (01) ◽

pp. 040-045

Author(s):

SARAH SAEED ◽

MOHAMMAD AKRAM

Keyword(s):

Ovarian Cancer ◽

Family History ◽

Epithelial Ovarian Cancer ◽

Positive Family History ◽

Striking Feature ◽

Brca1 And Brca2 ◽

Brca Mutations ◽

University Of Toronto ◽

Number Of Patients ◽

History Of

Background: Epithelial ovarian cancer is the most common cancer of gynaecologic origin in Pakistani women. It ranks amongthe ten most common cancers in our women. Despite being commonly encountered, information regarding the clinicopathological features islacking. Objective: To study the clinical and pathological features of epithelial ovarian cancer in our patients. Study Design: Retrospective study.Setting: Department of Medical Oncology, Jinnah Hospital Lahore. Period: Jan 01,2001 to Dec 31, 2002. Patients and methods: All patientswith histological or cytological diagnosis of epithelial ovarian cancer regardless of stage were included in the study. Information was obtainedfrom medical records which were reviewed thoroughly. Blood samples for analysis of BRCA mutations were sent to University of Toronto,Sunnybrook & Women’s College Health Sciences Centre, Toronto, Canada. Results: 75 patients were accrued. Mean age of the patients was47 years. The well defined risk factors such as nulliparity, lack of lactation, early menarche and late menopause were not present in the majorityof our patients. One striking feature was the number of patients with family history of cancer (18.7%). Majority were first degree relatives of thepatients and most had ovarian or breast cancer. BRCA1 and BRCA2 were seen in nine (12%) of the patients. Clinical presentation and histologicfeatures were similar to American and European patients, the only difference was that a large number (88%) of our patients presented withadvanced (stage III or IV) disease. Conclusions: Epithelial ovarian cancer manifests itself in a younger population of our women. Higherfrequency of positive family history was another striking feature of Pakistani patients.

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Risk and Protective Factors Associated with Ovarian Cancer among Two Egyptian Cohorts

Evidence-Based Nursing Research ◽

10.47104/ebnrojs3.v1i2.40 ◽

2019 ◽

Vol 1 (2) ◽

pp. 14

Author(s):

Sahar A. A. Ahmed ◽

Sahar Yassien

Keyword(s):

Risk Factors ◽

Ovarian Cancer ◽

Family History ◽

Early Detection ◽

Protective Factors ◽

Age At Menopause ◽

Factors Associated ◽

Low Fat Diet ◽

Significant Difference ◽

History Of

Context: Ovarian cancer is a global health crisis, as it is one of the devastating diagnoses for the patient and family. Nurse is a key person in the effort of health promotion, screening, and early detection. As well as care through the illness continuum. Aims: This study aims to determine the risk factors of ovarian cancer among two Egyptian cohorts, and to determine the possible protective factors of ovarian cancer among two Egyptian cohorts. Methods: A descriptive exploratory (Case/control) prospective research design used to achieve the study aim. The study conducted in two clinical settings those are National Cancer Institute (for cases), and El-Minia General Hospital (for controls). The study recruited 80 cases with a confirmed diagnosis of ovarian cancer, and 456 healthy controls without ovarian cancer. A structured interview questionnaire used to collect data regarding the presence of possible risk and protective factors. Results: The results of the present study revealed a highly statistically significant difference between cases and controls regarding their educational level, family history of ovarian cancer, types of other cancers, hysterectomy, and eating a low-fat diet at p<0.001. The study also showed a statistically significant difference regarding age at menopause, the degree of relationship with colorectal cancer relatives, and history of endometriosis at p<0.05. Conclusion: The study signifies the level of education, hysterectomy, late age at menopause, and eating low fat diet as a protective-factors against ovarian cancer, while signifies the positive family history of ovarian cancer, and endometriosis as risk factors associated with ovarian cancer. The study recommended trained health care providers to monitor trends in ovarian cancer occurrence, disparities in care and health assurance assistance, provide screening and early detection activities, care, education for healthy women who are at risk for ovarian cancer.

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