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A feasibility study of breast cancer genetic risk assessment in a federally qualified health center.
Hoskins, Kent F; Tejeda, Silvia; Vijayasiri, Ganga; Chukwudozie, Ifeanyi Beverly; Remo, Mylene H; Shah, Hiral A; Abraham, Ivy E; Balay, Lara E; Maga, Tara K; Searles, Ericka R; Korah, Veena J; Biggers, Alana; Stolley, Melinda R; Warnecke, Richard B.
Afiliação
  • Hoskins KF; Section of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
  • Tejeda S; Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
  • Vijayasiri G; Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
  • Chukwudozie IB; Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
  • Remo MH; Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
  • Shah HA; Section of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
  • Abraham IE; Section of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
  • Balay LE; Section of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
  • Maga TK; Section of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
  • Searles ER; Section of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
  • Korah VJ; Chicago Family Health Center, Chicago, Illinois.
  • Biggers A; Chicago Family Health Center, Chicago, Illinois.
  • Stolley MR; Section of General Internal Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
  • Warnecke RB; Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
Cancer ; 124(18): 3733-3741, 2018 09 15.
Article em En | MEDLINE | ID: mdl-30320429
ABSTRACT

BACKGROUND:

The US Preventive Services Task Force (USPSTF) endorses routine screening for genetic risk of breast and/or ovarian cancer as a component of primary health care. Implementation of this recommendation may prove challenging, especially in clinics serving disadvantaged communities.

METHODS:

The authors tested the feasibility of implementing the USPSTF mandate at a federally qualified health center (FQHC) to identify women who were eligible for genetic counseling (GC). A 12-month usual-care phase was followed by a 12-month intervention phase, during which time cancer genetic risk assessment (CGRA) was systematically performed for all women aged 25 to 69 years who presented for an annual examination. Women who were eligible for GC were recruited to participate in the study.

RESULTS:

After initiating CGRA, 112 women who were eligible for GC consented to study participation, and 56% of them received a referral for GC from their primary care physician. A subgroup of 50 participants were seen by the same primary care physician during both the usual-care and intervention phases. None of these patients was referred for GC during usual care, compared with 64% after the initiation of CGRA (P < .001). Only 16% of referred participants attended a GC session.

CONCLUSIONS:

Implementing USPSTF recommendations for CGRA as a standard component of primary health care in FQHCs is feasible and improves referral of minority women for GC, but more work is needed to understand the beliefs and barriers that prevent many underserved women from accessing cancer genetic services.
Assuntos
Neoplasias da Mama/diagnóstico; Neoplasias da Mama/genética; Testes Genéticos; Implementação de Plano de Saúde; Médicos de Atenção Primária/estatística & dados numéricos; Encaminhamento e Consulta/estatística & dados numéricos; Adulto; Idoso; Neoplasias da Mama/epidemiologia; Chicago/epidemiologia; Estudos de Viabilidade; Feminino; Financiamento Governamental; Aconselhamento Genético/economia; Aconselhamento Genético/organização & administração; Aconselhamento Genético/estatística & dados numéricos; Testes Genéticos/economia; Testes Genéticos/métodos; Testes Genéticos/estatística & dados numéricos; Implementação de Plano de Saúde/economia; Implementação de Plano de Saúde/organização & administração; Implementação de Plano de Saúde/estatística & dados numéricos; Disparidades nos Níveis de Saúde; Humanos; Programas de Rastreamento/economia; Programas de Rastreamento/métodos; Programas de Rastreamento/estatística & dados numéricos; Pessoa de Meia-Idade; Neoplasias Ovarianas/diagnóstico; Neoplasias Ovarianas/epidemiologia; Neoplasias Ovarianas/genética; Médicos de Atenção Primária/economia; Padrões de Prática Médica/economia; Padrões de Prática Médica/estatística & dados numéricos; Serviços Preventivos de Saúde/métodos; Atenção Primária à Saúde/métodos; Avaliação de Programas e Projetos de Saúde; Encaminhamento e Consulta/economia; Encaminhamento e Consulta/organização & administração; Medição de Risco; Estados Unidos/epidemiologia
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Encaminhamento e Consulta / Neoplasias da Mama / Testes Genéticos / Médicos de Atenção Primária / Implementação de Plano de Saúde Tipo de estudo: Diagnostic_studies / Etiology_studies / Evaluation_studies / Guideline / Prognostic_studies / Screening_studies / Sysrev_observational_studies País/Região como assunto: America do norte Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Encaminhamento e Consulta / Neoplasias da Mama / Testes Genéticos / Médicos de Atenção Primária / Implementação de Plano de Saúde Tipo de estudo: Diagnostic_studies / Etiology_studies / Evaluation_studies / Guideline / Prognostic_studies / Screening_studies / Sysrev_observational_studies País/Região como assunto: America do norte Idioma: En Ano de publicação: 2018 Tipo de documento: Article