Exploring Stakeholders' Perspectives on Implementing Universal Germline Testing for Colorectal Cancer: Findings From a Clinical Practice Survey

Authors

Linda Rodgers-Fouche
Sanjeevani Arora
Charité Ricker
Dan Li
Maheen Farooqi
Francesc Balaguer
Mev Dominguez-Valentin
Jose G Guillem
Priyanka Kanth
David Liska
Joshua Melson
Kathryn A Mraz
Brian H Shirts
Eduardo Vilar
Bryson W Katona
Rachel Hodan

Publication Date

9-1-2023

Journal

JCO Precision Oncology

DOI

10.1200/PO.23.00440

PMID

37897815

PMCID

PMC10860957

PubMedCentral® Posted Date

10-28-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Purpose: New guidelines recommend considering germline genetic testing for all patients with colorectal cancer (CRC). However, there is a lack of data on stakeholders' perspectives on the advantages and barriers of implementing universal germline testing (UGT). This study assessed the perspectives of members of the Collaborative Group of the Americas on Inherited Gastrointestinal Cancer (CGA-IGC) regarding the implementation of UGT for patients with CRC, including readiness, logistics, and barriers.

Methods: A cross-sectional survey was sent to 317 active members of CGA-IGC. The survey included sections on demographics, clinical practice specialty, established institutional practices for testing, and questions pertaining to support of and barriers to implementing UGT for patients with CRC.

Results: Eighty CGA-IGC members (25%) participated, including 42 genetic counselors (53%) and 14 gastroenterologists (18%). Forty-seven (59%) reported an academic medical center as their primary work setting, and most participants (56%) had more than 10 years of clinical practice. Although most participants (73%) supported UGT, 54% indicated that changes in practice would be required before adopting UGT, and 39% indicated that these changes would be challenging to implement. There was support for both genetics and nongenetics providers to order genetic testing, and a majority (57%) supported a standardized multigene panel rather than a customized gene panel. Key barriers to UGT implementation included limited genetics knowledge among nongenetics providers, time-consuming processes for obtaining consent, ordering tests, disclosing results, and lack of insurance coverage.

Conclusion: This study demonstrates wide support among hereditary GI cancer experts for implementation of UGT for patients with CRC. However, alternative service delivery models using nongenetics providers should be considered to address the logistical barriers to UGT implementation, particularly the growing demand for genetic testing.

Keywords

Humans, Cross-Sectional Studies, Genetic Testing, Surveys and Questionnaires, Colorectal Neoplasms

Published Open-Access

yes

Recommended Citation

Rodgers-Fouche, Linda; Arora, Sanjeevani; Ricker, Charité; et al., "Exploring Stakeholders' Perspectives on Implementing Universal Germline Testing for Colorectal Cancer: Findings From a Clinical Practice Survey" (2023). Faculty, Staff and Student Publications. 5078.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5078