Helping Cancer Genetic Testing Go Mainstream

Community-level hospitals could help specialist centers cope with the increased volume of ovarian cancer patients seeking genetic counselling and testing.

AsianScientist (Nov. 30, 2017) – In a study published in the Annals of Oncology, clinicians in Malaysia highlighted that ovarian cancer patients were satisfied with genetic testing and counselling by a trained non-genetic clinician at community hospitals. This suggests that genetic counselling need not be performed exclusively by specialist centers.

One in nine ovarian cancer patients carries the BRCA1 or BRCA2 (breast cancer gene 1 or 2) mutation and four in ten carriers do not have a family history of breast or ovarian cancer. Knowing one’s BRCA status may indicate how one may respond to certain therapies or the level of risk to develop certain cancers.

The Mainstreaming Genetic Counselling for Genetic Testing of BRCA1 and BRCA2 in Ovarian Cancer Patients in Malaysia (MaGiC) study was thus designed to assess the prevalence of germline BRCA1 and BRCA2 mutations among ovarian cancer patients. The data will also be used to determine the feasibility of mainstreaming genetic testing and counselling at local hospitals, as well as examine the psychosocial impact of genetic testing in Malaysia.

Under the MaGiC study, 800 ovarian cancer patients are to be recruited over a two-year period beginning in 2015. Basic genetic counselling workshops have been held for 70 non-genetic clinicians from 29 hospitals across Malaysia.

According to the study protocol, patients are allocated to two groups: counselling by a trained non-genetic clinician in their local hospital or counselling by a genetic counsellor or clinical at specialized centers in Kuala Lumpur. All blood samples are analyzed for BRCA mutations by Cancer Research Malaysia. After both pre- and post-test counselling, they are interviewed by a researcher over the telephone to assess the feasibility and the psychosocial impact of the experience.

One year into the study, 248 patients have been recruited, of whom 208 received genetic testing and 13 percent had BRCA mutations, which is similar to that found in other populations. Preliminary results showed that patients in the local and specialized counselling arms were equally satisfied or very satisfied with the counselling they received. The local counselling arm has been recruiting patients more quickly than the specialized arm.

“Screening for BRCA1 and BRCA2 mutations and providing genetic counselling in local hospitals could help identify mutation carriers who may benefit from risk management and targeted treatment,” said lead author Ms. Yoon Sook-Yee, genetic counsellor, Cancer Research Malaysia.

“Mainstreaming genetic testing and counselling to local hospitals is a strategy to cope with this increased volume of patients,” said Dr. Lee Soo Chin, Senior Consultant, National University Cancer Institute, Singapore, commenting on the study. “The preliminary results of the study show that moving the genetic counselling process to the community is feasible and could be rolled out across Malaysia. It also is a model for other countries like Singapore to follow.”



The article can be found at: Yoon et al. (2017) Mainstreaming Genetic Counselling for Genetic Testing of BRCA1 and BRCA2 in Ovarian Cancer Patients in Malaysia (MaGiC Study).

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Source: European Society for Medical Oncology; Photo: Shutterstock.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.

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