Evaluation of a new genetic family history screening questionnaire for identifying Lynch syndrome

Harrison, Dawn S.; Handley, Marilyn

doi:10.1097/01.npr.0000515425.45908.af

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…In this study, network failures occurred when providers did not access documentation that might have informed care, including documented cancer family history. Better genetic family history taking may improve identification of high-risk patients [ 56 ], but electronic systems need to support that. EHR-supported family history information/triggers may be especially important in the primary care setting, where change in provider assignment may be common and where providers frequently operate as members of a care team.…”

Section: Discussionmentioning

confidence: 99%

Tracing the potential of networks to improve community cancer care: an in-depth single case study

Ridgeway

Boardman

Griffin

et al. 2021

Implement Sci Commun

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Background Despite overall declines in cancer mortality in the USA over the past three decades, many patients in community settings fail to receive evidence-based cancer care. Networks that link academic medical centers (AMCs) and community providers may reduce disparities by creating access to specialized expertise and care, but research on network effectiveness is mixed. The objective of this study was to identify factors related to whether and how an exemplar AMC network served to provide advice and referral access in community settings. Methods An embedded in–depth single case study design was employed to study a network in the Midwest USA that connects a leading cancer specialty AMC with community practices. The embedded case units were a subset of 20 patients with young-onset colorectal cancer or risk-related conditions and the providers involved in their care. The electronic health record (EHR) was reviewed from January 1, 1990, to February 28, 2018. Social network analysis identified care, advice, and referral relationships. Within-case process tracing provided detailed accounts of whether and how the network provided access to expert, evidence-based care or advice in order to identify factors related to network effectiveness. Results The network created access to evidence-based advice or care in some but not all case units, and there was variability in whether and how community providers engaged the network, including the path for referrals to the AMC and the way in which advice about an evidence-based approach to care was communicated from AMC specialists to community providers. Factors related to instances when the network functioned as intended included opportunities for both rich and lean communication between community providers and specialists, coordinated referrals, and efficient and adequately utilized documentation systems. Conclusions Network existence alone is insufficient to open up access to evidence-based expertise or care for patients in community settings. In-depth understanding of how this network operated provides insight into factors that support or inhibit the potential of networks to minimize disparities in access to evidence-based community cancer care, including both personal and organizational factors.

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Section: Discussionmentioning

confidence: 99%

Tracing the potential of networks to improve community cancer care: an in-depth single case study

Ridgeway

Boardman

Griffin

et al. 2021

Implement Sci Commun

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“…FHH is underutilized as a screening tool. 3,4 Factors contributing to underutilization include lack of provider time and knowledge, lack of patient knowledge regarding their family history, and lack of a standardized format for collection. 3,5,6 Patients can benefi t from frequent and earlier screening, medical interventions, and genetic counseling in coordination with their FHH.…”

Section: ■ Problem Descriptionmentioning

confidence: 99%

“…When empowered with an accurate FHH, a patient can be proactive in managing their health and the information can guide the provider to recommending further testing or consultations when warranted. FHH is underutilized as a screening tool 3,4. Factors contributing to underutilization include lack of provider time and knowledge, lack of patient knowledge regarding their family history, and lack of a standardized format for collection 3,5,6.…”

Section: Available Knowledgementioning

confidence: 99%

Establishing a process to improve the collection of family health history

Andrusko

Paradiso

2022

The Nurse Practitioner

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Knowledge of a person's potential to inherit certain diseases has rapidly become a valuable part of the discussion between provider and patient. Knowing the risk of hereditary disorders allows providers to include screening and diagnostic tests in a timely way. The family heath history is an easy and important tool for identifi cation of risk for genetic diseases, including cancers. A project, which incorporated patient education and technology, was developed to improve the collection of family health history and identify high-risk patientsfor genetic cancers and/or diseases.

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Colorectal Cancer Screening Practices Among Texas Nurse Practitioners and Physician Assistants

Laird

Raudonis

2020

Gastroenterology Nursing

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The purpose of this study was two-fold: (1) To describe and compare Texas Nurse Practitioners' and Physician Assistants' knowledge and use of current screening guidelines for individuals at varying risk for colorectal cancer and (2) to compare their recommendations for referral for genetic counseling for persons at increased risk for colorectal or endometrial cancer. The study used a descriptive correlational comparative design. A self-administered web-based survey was sent to the members of the Texas Nurse Practitioner Association and the Texas Academy of Physician Assistants. The questionnaire consisted of 44 items categorized in three domains: demographics, knowledge of national guidelines for risk-stratified colorectal cancer (CRC) screening, and referral for genetic counseling and CRC-screening practices. Data were collected from July through October 2014. More than 75% of the survey respondents reported confidence in their knowledge of the lifetime risk of colorectal cancer and the recommendations for screening in the average-risk adult. Fifty-one percent of both groups reported that they were familiar with Lynch syndrome; however, the nurse practitioners had a lower awareness of the lifetime risk of colorectal cancer associated with Lynch syndrome compared to the physician assistants. Only 34.1% of the nurse practitioners and 23.5% of the physician assistants were aware of the lifetime risk of developing endometrial cancer diagnosed before 60 years of age in women with Lynch syndrome, and only 39.6% of the physician assistants and 40% of the nurse practitioners reported performing a three-generation family history of cancer as a risk assessment. Less than 50% of the respondents would refer a patient with a personal or family history of colorectal or endometrial cancer diagnosed before the age of 60 years for genetic counseling. Nurse practitioners and physician assistants in primary care need more formal and continuing education in risk-stratified screening and referral for genetic counseling in adults at increased risk for colorectal cancer. The academic curricula of both disciplines need to include more content on genetic and genomic influences on the pathophysiology of colorectal cancer and the role of this information for screening and personalized treatment.

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Evaluation of a new genetic family history screening questionnaire for identifying Lynch syndrome

Abstract: Family history is essential when screening for hereditary cancer syndromes. This article explores if a detailed genetic family history questionnaire is more effective in identifying at-risk individuals for Lynch syndrome than a basic family health questionnaire.

Cited by 3 publications

References 25 publications

Tracing the potential of networks to improve community cancer care: an in-depth single case study

Tracing the potential of networks to improve community cancer care: an in-depth single case study

Establishing a process to improve the collection of family health history

Colorectal Cancer Screening Practices Among Texas Nurse Practitioners and Physician Assistants

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