2016
DOI: 10.1097/coc.0000000000000073
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Adherence Patterns to National Comprehensive Cancer Network Guidelines for Referral of Women With Breast Cancer to Genetics Professionals

Abstract: Genetic counseling and testing is being underutilized in women who meet NCCN referral guidelines. Age and family history were noted to be predictive of referral for genetic evaluation. Further research is needed to determine additional factors that may impact not only referral rates but subsequent care for women with possible genetic predispositions to cancer.

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Cited by 43 publications
(43 citation statements)
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“…Given that receipt of a referral from a healthcare provider was the strongest predictor of accessing genetic services in both our study and the recent McCarthy et al study [24], improving appropriate referral rates is critical. Our model indicates that diagnosis at or below age 45 and triple negative disease are both associated with referral, which suggests that healthcare providers recognize that these risk factors confer an increased likelihood of hereditary breast cancer, consistent with other research [31]. On the other hand, in contrast to a recent study [31], family history of cancer does not appear to strongly influence referral practices of healthcare providers in our study.…”
Section: Discussionsupporting
confidence: 87%
See 1 more Smart Citation
“…Given that receipt of a referral from a healthcare provider was the strongest predictor of accessing genetic services in both our study and the recent McCarthy et al study [24], improving appropriate referral rates is critical. Our model indicates that diagnosis at or below age 45 and triple negative disease are both associated with referral, which suggests that healthcare providers recognize that these risk factors confer an increased likelihood of hereditary breast cancer, consistent with other research [31]. On the other hand, in contrast to a recent study [31], family history of cancer does not appear to strongly influence referral practices of healthcare providers in our study.…”
Section: Discussionsupporting
confidence: 87%
“…Our model indicates that diagnosis at or below age 45 and triple negative disease are both associated with referral, which suggests that healthcare providers recognize that these risk factors confer an increased likelihood of hereditary breast cancer, consistent with other research [31]. On the other hand, in contrast to a recent study [31], family history of cancer does not appear to strongly influence referral practices of healthcare providers in our study. Despite this conflicting finding, our results are consistent with studies that suggest inadequate elicitation and documentation of cancer family history in medical records [16,32,33].…”
Section: Discussionsupporting
confidence: 87%
“…The variation in the application of the NCCN suggested tests is consistent with previous observations. 16,29,30 Adherence to established guidance for cancer management can have a positive effect on quality of care, and compliance with NCCN guidelines has been shown to improve survival by > 30%. 16,31 Altogether, a complete baseline diagnostic work-up is essential to optimize the treatment plan and monitor response in NDMM patients.…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, our finding that 30 % of women diagnosed with TNBC in this age group had a deleterious BRCA 1/2 mutation is not surprising. In clinical practice, available literature suggests that genetic counseling and testing is being underutilized in women who meet NCCN referral guidelines [17] but the magnitude to which counseling and testing is underperformed in minority populations has not been well investigated and is not addressed with this study.…”
Section: Discussionmentioning
confidence: 99%