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Evaluating women with ovarian cancer for BRCA1 and BRCA2 mutations: missed opportunities.
- Source :
-
Obstetrics & Gynecology . May2010, Vol. 115 Issue 5, p945-952. 8p. - Publication Year :
- 2010
-
Abstract
- <bold>Objective: </bold>To estimate the incidence of genetic counseling referral for ovarian cancer patients who are at substantial risk for a BRCA1 or BRCA2 mutation.<bold>Methods: </bold>An analysis was performed of new ovarian cancer patients who were seen at a comprehensive cancer center from January 1, 1999, through December 31, 2007. Patients at substantial (more than 20-25%) risk for a BRCA1 or BRCA2 mutation were identified and records reviewed for referral to genetic counseling. Time to referral was estimated using the Kaplan-Meier method.<bold>Results: </bold>A total of 3,765 epithelial ovarian cancer patients were seen during the 9-year period. On average, 23.8% of patients met substantial-risk criteria for BRCA mutations. In 1999, only 12% of patients at substantial-risk were referred. Referral improved over time with 48% referred in 2007 (P<.001). Newly diagnosed patients were more often referred for genetic counseling than new patients with recurrent disease or those seen as second opinions. African-American women meeting substantial-risk criteria were less likely to be referred than were white or Hispanic women (P=.009).<bold>Conclusion: </bold>Although dictated family history was accurate, interpretation of risk for BRCA1 or BRCA2 mutations and subsequent referral to genetic counseling was poor. Although there was significant improvement over time, 50% of substantial-risk patients still were missed. Systematic efforts to identify those ovarian cancer patients at substantial risk for a BRCA1 or BRCA2 are necessary. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00297844
- Volume :
- 115
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Obstetrics & Gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 105181348
- Full Text :
- https://doi.org/10.1097/AOG.0b013e3181da08d7