Physician Experiences and Understanding of Genomic Sequencing in Oncology

Abstract

The amount of information produced by genomic sequencing is vast, technically complicated, and can be difficult to interpret. Appropriately tailoring genomic information for non-geneticists is an essential next step in the clinical use of genomic sequencing. To initiate development of a framework for genomic results communication, we conducted eighteen qualitative interviews with oncologists who had referred adult cancer patients to a matched tumor-normal tissue genomic sequencing study. In our qualitative analysis, we found varied levels of clinician knowledge relating to sequencing technology, the scope of the tumor genomic sequencing study, and incidental germline findings. Clinicians expressed a perceived need for more genetics education. Additionally, they had a variety of suggestions for improving results reports and possible resources to aid in results interpretation. Most clinicians felt genetic counselors were needed when incidental germline findings were identified. Our research suggests that more consistent genetics education is imperative in ensuring the proper utilization of genomic sequencing in cancer care. Clinician suggestions for results interpretation resources and results report modifications could be used to improve communication. Clinicians' perceived need to involve genetic counselors when incidental germline findings were found suggests genetic specialists could play a critical role in ensuring patients receive appropriate follow-up.

Attitudes and Practices of Australian Nephrologists Toward Implementation of Clinical Genomics

“…Moreover, those who had genomic education were more likely to prefer the multidisciplinary model, suggesting that recognising the complexities that accompany genomic testing may inform clinician choices. Most respondents indicated minimal involvement with counseling and result disclosure, in keeping with sub-specialist surveys which highlight a strong desire for additional genetics support, especially around result return 26,27 . Increasing support for multidisciplinary clinics should be a priority for policy makers to help nephrologists better serve individuals with genetic kidney disease.…”

Preparing Medical Specialists for Genomic Medicine: Continuing Education Should Include Opportunities for Experiential Learning

“…A foundational, baseline understanding of genomic concepts allows a common language to be used and understood in communication, then practical training is needed to convert fundamental understanding into confident practice (Stanek et al, 2012). This common language and understanding would encourage good relationships between scientists and clinicians, which is essential for efficient clinical outcomes (Burton et al, 2017;Weipert et al, 2018).…”

“…The challenges for medical specialists to integrate genomic medicine into their clinical practice have only been investigated in a piecemeal approach so far, with most studies involving hospital-based specialists from the same specialty. For example, in studies involving oncologists, clinicians reported feeling underprepared to comprehend and communicate genomic test results despite practicing in areas in which the clinical utility of genomic investigations for some conditions or some patients was established and testing was available (Chow-White et al, 2017;Johnson et al, 2017;Weipert et al, 2018). While expressing familiarity with discussing genetic information, cardiologists in the MedSeq study similarly felt underprepared to navigate complex genomic test results, particularly those that lay outside their specialty (Christensen et al, 2016).…”

Oncologist Confidence in Genomic Testing and Implications for Using Multimarker Tumor Panel Tests in Practice

“… 6 In addition, providers vary in their understanding of how to interpret and act upon results from whole-genome sequencing, which is not available outside of clinical trials. 16 Given the potential of precision oncology, there is a need to better understand oncologists’ attitudes and experiences with genomic testing and to identify factors that foster genomic testing confidence.…”