Implementing mainstreaming of genetic testing of women with ovarian cancer: Evaluation of a training program for oncology health professionals

Bettina Meiser, Margaret Gleeson, Maira Kentwell, Natalie Taylor, Kathy Tucker, Judy Kirk, Kristine Barlow-Stewart, Michael Friedlander
 
Traditionally, many women newly diagnosed with ovarian cancer and a strong family history of breast and/or ovarian cancer have been referred to a family cancer clinic (FCC) for genetic counselling and consideration of genetic testing for germline mutations in cancer predisposition genes (BRCA1 and BRCA2) following completion of their cancer treatment. However, there is now growing evidence that BRCA mutation status is increasingly used to make specific treatment recommendations and that increasing numbers of women will be offered genetic testing shortly after a diagnosis of ovarian cancer. The current paradigm of intensive genetic counselling needs to move to a more streamlined clinical pathway that captures a larger proportion of women with high grade epithelial ovarian cancer. Accordingly, a nationwide clinical training initiative is introducing ‘mainstreaming’ of genetic testing for women with ovarian cancer, where ‘mainstreaming’ refers to genetic testing being offered to women by nongenetics oncology health professionals, rather than genetics professionals at FCCs, to enable the implementation of more widespread genetic testing of women with ovarian cancer.
 
In total, 16 FCCs across Australia are participating in this clinical and research initiative. The heads of each FCCs or a nominated senior genetic counsellor will deliver inservice training locally to medical oncologists and other relevant oncology health professionals at 20 different hospital sites associated with these FCCs. Data will be collected via online surveys from oncology health professionals and staff at the FCCs to assess for the success of implementing mainstreaming of genetic testing. Findings from this study will be used to optimise the way genetic testing is offered to women in the future and to address barriers to successful implementation.