The Value of a Genetic Counselor: Improving Identification of Cancer Genetic Counseling Patients with Chart Review

Abstract

Advances in genetics are changing cancer care and requiring institutions to maximize the unique skills of genetics professionals. The identification of genetic syndromes is vital for prevention and management of families with high cancer risks. Despite this, high risk individuals who qualify are often not referred. Genetic counselors could review oncology charts to improve identification. A genetics assessment tool developed by NCI Community Cancer Centers Program was used to perform self-assessment of the genetics program. A weekly report of all new oncology patients was provided to a genetic counselor for chart review. In 2010, 58 % of all eligible patients (n = 152) were offered a genetics evaluation. In 2011 this improved to 70 % (n = 167), which was a statistically significant difference, X (2)(1) = 5.13, p = 0.02. By cancer site, ovarian cancer referrals also showed statistically significant improvement, X (2)(1) = 6.36, p = 0.01. Breast and colon referrals were improved but not significant. Over 10 months, 129 patients were identified through the chart review program. Three were confirmed to have a genetic mutation for a hereditary cancer syndrome. An average week included review of 73 charts for 10 medical oncologists, 4 radiation oncologists, and 4 pediatric oncologists which generated 60-80 min of work for the genetic counselor. This program improved patient identification and quality, and allowed physicians to become more aware of opportunities for genetic counseling and more patients to receive genetic counseling and testing.

Evolution of genetic assessment for BRCA-associated gynaecologic malignancies: a Canadian multisociety roadmap

“…In some centres, genetic counsellors help to increase genetic referral rates for patients with ovarian cancer. For example, Eichmeyer et al reported that a weekly review of all new oncology patients by a genetic counsellor improved cancer genetics referral rates from 50% to 70% overall, from 29% to 91% for patients with ovarian cancer and increased genetic counselling volumes by 11% 43. Another study reported that genetics referral rates for patients with ovarian cancer improved from 26.7% to 51.7% after a genetic counsellor began attending oncology tumour board meetings 44.…”

High‐Risk Palliative Care Patients’ Knowledge and Attitudes about Hereditary Cancer Testing and DNA Banking

“…Both patient and provider education are needed to ensure access. Genetic counselors may contact local oncology and/or palliative care services to offer education, consultation services, chart reviews, and/or attendance at clinic conferences like tumor boards (Cohen et al 2016;Eichmeyer et al 2014). Other resources offer practical advice that can be shared with end-of-life care providers (Quillin et al 2008b(Quillin et al , 2011aRoeland et al 2017).…”

The Importance of Infrastructure Facilities in Counseling Services

“…Considerations in program making, quality improvement and quantity of infrastructure for solutions to problems of nonimplementation of counseling services are one of the key factors for counselor. In improving the quality of these infrastructure facilities is not separated from the role of principals [40] [41].…”