Implementation of interventions targeting the uptake of genetic testing services for breast cancer risk: protocol for a systematic review

Abstract

IntroductionThe timely identification of breast cancer-related pathogenic variants can help to identify the risk of potential disease development and determine healthcare choices. However, the uptake rate of genetic testing services for breast cancer risk remains low in many countries. Interventions targeting the uptake of these services among individuals potentially at risk for inherited breast cancer are often complex and have multiple components, and are therefore difficult to implement, replicate and disseminate to new contexts. Our aim is to systematically review studies targeting the uptake of genetic testing services for breast cancer risk and critically assess the quality of implementation outcomes and the reporting of intervention descriptions.Methods and analysisPubMed, CINAHL, PsycINFO, Embase, Cochrane Library and all Campbell Coordinating Group databases will be searched for intervention studies that target individuals' participation in breast cancer genetic testing programmes. Papers published in English within the time period from January 2005 until October 2019 will be considered for inclusion. Titles, abstracts and full papers will be screened for eligibility by two pairs of reviewers independently. For data analysis and synthesis, study-level and intervention-level characteristics will be abstracted. We will present all implementation outcomes that are mentioned in each of the studies and register the number of studies that do not at all look at or report implementation outcomes. The quality of implementation will be checked using a 5-point rubric item, and the quality and completeness of reporting of intervention description will be evaluated using the 12-item Template for Intervention Description and Replication (TIDieR).Ethics and disseminationEthical approval is not required to conduct this review. Review findings will be disseminated to academic and non-specialist audiences via peer-reviewed academic journals and presented at appropriate conferences, workshops and meetings to policymakers, practitioners and organisations that work with our population of interest.PROSPERO registration numberCRD42018105732.

Assessing the impact of developments in genetic testing on insurers' risk exposure

“…In a systematic review of uptake rates for breast cancer genetic testing, uptake rates ranged from 25% to 96% (mean 59%) across different population groups and contexts (data from the UK, USA and Canada); personal and family history of breast cancer were the only consistent predictors of uptake [137]. There is evidence that uptake rates are lower in subgroups with lower education, lower income and/or in those with an ethnic minority background [138,139].…”