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Evaluation of implementation of risk management guidelines for carriers of pathogenic variants in mismatch repair genes: a nationwide audit of familial cancer clinics.
Meiser, B; Kaur, R; Kirk, J; Morrow, A; Peate, M; Wong, W K T; McPike, E; Cops, E; Dowson, C; Austin, R; Fine, M; Thrupp, L; Ward, R; Macrae, F; Hiller, J E; Trainer, A H; Mitchell, G.
Afiliación
  • Meiser B; Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, Australia. b.meiser@unsw.edu.au.
  • Kaur R; Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, Australia.
  • Kirk J; Crown Princess Mary Cancer Centre at Westmead Hospital, Sydney, Australia.
  • Morrow A; Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney Medical School, University of Sydney, Sydney, Australia.
  • Peate M; Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, Australia.
  • Wong WKT; Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, Australia.
  • McPike E; Department of Obstetrics and Oncology, Royal Women's Hospital, University of Melbourne, Melbourne, Australia.
  • Cops E; Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, Australia.
  • Dowson C; School of Social Sciences, UNSW Sydney, Sydney, Australia.
  • Austin R; Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, Australia.
  • Fine M; Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Australia.
  • Thrupp L; Royal Melbourne Hospital, Melbourne, Australia.
  • Ward R; Genetic Services of Western Australia, King Edward Memorial Hospital, Perth and School of Medicine, University of Western Australia, Perth, Australia.
  • Macrae F; Royal Brisbane and Women's Hospital, Genetic Health Queensland, Herston, QLD, Australia.
  • Hiller JE; Adult Genetics Unit, Royal Adelaide Hospital, Adelaide and School of Medicine, University of Adelaide, Adelaide, Australia.
  • Trainer AH; Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Australia.
  • Mitchell G; University of Queensland, Brisbane, Australia.
Fam Cancer ; 19(4): 337-346, 2020 10.
Article en En | MEDLINE | ID: mdl-32385704
INTRODUCTION: This nationwide study assessed the impact of Lynch syndrome-related risk management guidelines on clinicians' recommendations of risk management strategies to carriers of pathogenic variants in mismatch repair genes and the extent to which carriers took up strategies in concordance with guidelines. MATERIALS AND METHODS: Clinic files of 464 carriers (with and without colorectal cancer) were audited for carriers who received their genetic testing results in July 2008-July 2009 (i.e. before guideline release), July 2010-July 2011 and July 2012-July 2013 (both after guideline release) at 12 familial cancer clinics (FCCs) to ascertain the extent to which carriers were informed about risk management in accordance with guidelines. All carriers captured by the audit were invited to participate in interviews; 215 were interviewed to assess adherence to recommended risk management guidelines. RESULTS: The rates of documentation in clinic files increased significantly from pre- to post-guideline for only two out of eight risk management strategies. The strategies with the highest compliance of carriers post-guidelines were: uptake of one or two-yearly colonoscopy (87%), followed by hysterectomy to prevent endometrial cancer (68%), aspirin as risk-reducing medication (67%) and risk-reducing salpingo-oophorectomy (63%). Interrater reliability check for all guidelines showed excellent agreement (k statistics = 0.89). CONCLUSION: These results indicate that there is scope to further increase provision of advice at FCCs to ensure that all carriers receive recommendations about evidence-based risk management. A multi-pronged behaviour change and implementation science approach tailored to specific barriers is likely to be needed to achieve optimal clinician behaviours and outcomes for carriers.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales Hereditarias sin Poliposis / Medición de Riesgo / Adhesión a Directriz / Reparación de la Incompatibilidad de ADN / Heterocigoto Tipo de estudio: Etiology_studies / Guideline / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Fam Cancer Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales Hereditarias sin Poliposis / Medición de Riesgo / Adhesión a Directriz / Reparación de la Incompatibilidad de ADN / Heterocigoto Tipo de estudio: Etiology_studies / Guideline / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Fam Cancer Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Países Bajos