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Erschienen in: Journal of Genetic Counseling 4/2017

16.01.2017 | Original Research

Large, Prospective Analysis of the Reasons Patients Do Not Pursue BRCA Genetic Testing Following Genetic Counseling

verfasst von: Sommer Hayden, Sarah Mange, Debra Duquette, Nancie Petrucelli, Victoria M. Raymond, on behalf of the BRCA Clinical Network Partners

Erschienen in: Journal of Genetic Counseling | Ausgabe 4/2017

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Abstract

Genetic counseling (GC) and genetic testing (GT) identifies high-risk individuals who benefit from enhanced medical management. Not all individuals undergo GT following GC and understanding the reasons why can impact clinical efficiency, reduce GT costs through appropriate identification of high-risk individuals, and demonstrate the value of pre-GT GC. A collaborative project sponsored by the Michigan Department of Health and Human Services prospectively collects anonymous data on BRCA-related GC visits performed by providers in Michigan, including demographics, patient/family cancer history, GT results, and reasons for declining GT. From 2008 to 2012, 10,726 patients underwent GC; 3476 (32.4%) did not pursue GT. Primary reasons included: not the best test candidate (28.1%), not clinically indicated (23.3%), and insurance/out of pocket cost concerns (13.6%). Patient disinterest was the primary reason for declining in 17.1%. Insurance/out of pocket cost concerns were the primary reason for not testing in 13.4% of untested individuals with private insurance. Among untested individuals with breast and/or ovarian cancer, 22.5% reported insurance/out of pocket cost concerns as the primary reason for not testing and 6.6% failed to meet Medicare criteria. In a five-year time period, nearly one-third of patients who underwent BRCA GC did not pursue GT. GT was not indicated in almost half of patients. Insurance/out of pocket cost concerns continue to be barriers.
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Metadaten
Titel
Large, Prospective Analysis of the Reasons Patients Do Not Pursue BRCA Genetic Testing Following Genetic Counseling
verfasst von
Sommer Hayden
Sarah Mange
Debra Duquette
Nancie Petrucelli
Victoria M. Raymond
on behalf of the BRCA Clinical Network Partners
Publikationsdatum
16.01.2017
Verlag
Springer US
Erschienen in
Journal of Genetic Counseling / Ausgabe 4/2017
Print ISSN: 1059-7700
Elektronische ISSN: 1573-3599
DOI
https://doi.org/10.1007/s10897-016-0064-5

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