Live Virtual Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

The development and evaluation of a nationwide training program for oncology health professionals in the provision of genetic testing for ovarian cancer patients (#12)

Bettina Meiser 1 , Margaret gleeson 2 , Maira Kentwell 3 , Judy Do 1 , suzanne nevin 1 , Natalie Taylor 4 , Kristine Barlow-Stewart 5 , Judy Kirk 6 , Paul James 3 , Clare L Scott 3 , Rachel Williams 7 , Kimberley Gamet 8 , Jo Burke 9 , Morgan Murphy 3 , Yoland Antill 3 , Amy Pearn 10 , Nicholas Pachter 11 , Camron Ebzery 11 , Nicola Poplawski 12 , Michael Friedlander 1 , Kathy Tucker 7
  1. Prince of Wales Clinical School, UNSW Australia, Sydney, NSW, Australia
  2. Hunter Family Cancer Service, Newcastle, NSW
  3. Parkville Family Cancer Clinic, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, NSW
  4. Cancer Council, Sydney, NSW, Australia
  5. Centre for Genetics Education , St Leonards , NSW, Australia
  6. Familial Cancer Service, Westmead Hospital and Sydney Medical School, University of Sydney, Westmead
  7. Hereditary Cancer Clinic, Prince of Wales Hospital, Prince of Wales Hospital, Randwick, NSW, Australia
  8. Genetic Health Service NZ Northern Hub, Auckland City Hospital, Auckland
  9. Tasmanian Clinical Genetics Service, Royal Hobart Hospital, Hobart
  10. Familial Cancer Program, Genetic Services of Western Australia, Perth
  11. Familial Cancer Program, Genetic Services of Western Australia, Perth
  12. Adult Genetics Unit, Royal Adelaide Hospital, Adelaide

Background: BRCA1/2 mutation status has increasing relevance for ovarian cancer treatments, making traditional coordination of genetic testing by genetic services unsustainable. Consequently alternative models of genetic testing have been developed to improve testing at the initial diagnosis for all eligible women.

Methods: A training module to enable mainstreamed genetic testing by oncology healthcare professionals was developed by genetic health professionals.  Oncology healthcare professionals completed questionnaires before and 12 months post-training to assess perceived skills, competence and barriers to their coordinating genetic testing for women with high-grade non-mucinous epithelial ovarian cancer.  Genetic health professionals were surveyed 12 months post-training to assess perceived barriers to implementation of mainstreaming.

Results: 185 oncology healthcare professionals were trained in 42 workshops at 35 Australasian hospitals. Of the 273 tests ordered by oncology healthcare professionals post-training, 241 (93.1%) met national testing guidelines. The number of tests ordered by genetic health professionals reduced significantly (z=45.0, p=0.008). Oncology healthcare professionals’ perceived barriers to mainstreamed testing decreased from baseline to follow-up (t=2.39, p=0.023), particularly perceived skills, knowledge and attitudes. However, only 58% reported either ‘always’ or ‘nearly always’ having ordered BRCA testing for eligible patients at 12 months, suggesting oncology healthcare professionals’ perceived barriers were not systematically addressed through training.

Conclusions: Oncology healthcare professionals have demonstrated a willingness to be involved in the provision of genetic testing in a mainstreaming model. If oncology services are to hold responsibility for coordinating genetic testing, their readiness will require understanding of barriers not addressed by training alone to inform future intervention design.