Implementing a Screening Tool for Identifying Patients at Risk for Hereditary Breast and Ovarian Cancer: A Statewide Initiative
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The Georgia Breast Cancer Genomic Health Consortium is a partnership created with funding from the Centers for Disease Control and Prevention (CDC) to the Georgia Department of Public Health to reduce cancer disparities among high-risk minority women. The project addresses young women at increased risk for hereditary breast and ovarian cancer (HBOC) syndrome through outreach efforts.
The consortium provides education and collects surveillance data using the breast cancer genetics referral screening tool (B-RST) available at www.BreastCancerGeneScreen.org. The HBOC educational protocol was presented to 73 staff in 6 public health centers. Staff used the tool during the collection of medical history. Further family history assessments and testing for mutations in the BRCA1/2 genes were facilitated if appropriate.
Data was collected from November 2012 through December 2013, including 2,159 screened women. The majority of patients identified as black/African American and were 18–49 years old. Also, 6.0 % (n = 130) had positive screens, and 60.9 % (n = 67) of the 110 patients who agreed to be contacted provided a detailed family history. A total of 47 patients (42.7 %) met National Comprehensive Cancer Network guidelines when family history was clarified. Fourteen (12.7 %) underwent genetic testing; 1 patient was positive for a BRCA2 mutation, and 1 patient was found to carry a variant of uncertain significance.
The introduction of genomics practice within public health departments has provided access to comprehensive cancer care for uninsured individuals. The successful implementation of the B-RST into public health centers demonstrates the opportunity for integration of HBOC screening into primary care practices.
KeywordsNational Comprehensive Cancer Network National Comprehensive Cancer Network Minority Woman Public Health Center United States Preventive Service Task Force
The authors are in appreciation of a funding opportunity award in the form of a Cooperative Agreement from the Centers for Disease Control and Prevention to the Georgia Department of Public Health, administered by the Georgia Center for Oncology Research and Education in partnership with Emory University, Morehouse School of Medicine, and Georgia State University. The authors would also like to acknowledge the staff at the Department of Public Health, including those members at the individual public health centers that are currently administering the initial screening tool. Most importantly, we acknowledge, the clients who agree to screening, especially those who agree to be contacted further and proceed with testing. Finally, we acknowledge the Wilbur and Hilda Glenn Family Foundation and Winship Cancer Institute of Emory University’s Glenn Family Breast Center for providing pilot funding that led to Georgia’s successful CDC grant award.
Alice Kerber: Pfizer Inc., speakers bureau.
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