1. Impact of a genetic counseling requirement prior to genetic testing
- Author
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Trang H. Au, Diana I. Brixner, Vanessa Stevens, Johnathan M. Lancaster, David D. Stenehjem, Hillevi Bauer, Krystal Brown, and Amy Sainski
- Subjects
Adult ,medicine.medical_specialty ,Multivariate analysis ,Genetic testing ,Adolescent ,Genetic counseling ,Decision Making ,Genes, BRCA2 ,Genes, BRCA1 ,Breast Neoplasms ,Genetic Counseling ,Decisional conflict ,Cancer screening ,Conflict, Psychological ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Surveys and Questionnaires ,Medicine ,Humans ,Patient survey ,Genetic Predisposition to Disease ,030212 general & internal medicine ,Insurance, Health ,medicine.diagnostic_test ,business.industry ,lcsh:Public aspects of medicine ,Health Policy ,Public health ,lcsh:RA1-1270 ,Middle Aged ,Breast cancer susceptibility genes ,Organizational Policy ,Test (assessment) ,030220 oncology & carcinogenesis ,Household income ,Hereditary breast and ovarian cancer syndrome ,Female ,Health Services Research ,business ,Demography ,Research Article - Abstract
Background Genetic counseling by a Genetic Counselor (GC) is a requirement prior to genetic testing for cancer susceptibility genes (GC-mandate policy) for some insurers. This study evaluated the impact of this policy from the patient perspective. Methods Surveys were sent to individuals for whom their insurer ordered genetic testing for the cancer susceptibility genes BCRA1 and BRCA2 over a 1 year time period that spanned the introduction of a GC-mandate policy. Responses were assessed by time period (before/after policy introduction) and genetic test completion. Results The surveys were completed by 1247/4950 (25.7%) eligible individuals. After policy introduction, there was no change in the proportion of respondents who completed genetic testing (p = 0.13) or had a mutation (p = 0.55). Overall decisional conflict (uncertainty or feeling uninformed) around genetic testing did not change after policy introduction (p = 0.16), but was significantly higher among respondents who did not complete genetic testing (p
- Published
- 2018