In 2014, NCCN guidelines for ovarian cancer were updated to include genetic risk assessment for all women diagnosed with ovarian cancer, following the introduction of PARP inhibitors for targeted treatment*. Despite the advancements made in cancer genetics knowledge and the availability of cancer predisposition testing, little information has been gathered regarding the decision-making of providers in the referral process of their patients for cancer genetic risk evaluation.
We aimed to determine characteristics of the population of patients referred for genetics consultation upon receiving a diagnosis of ovarian cancer that distinguish them from those who are not referred. Data collected at the University of California, Irvine Medical Center covering a two-year time span following the NCCN update was analyzed. Our study found that women with ovarian cancer continue to be under-referred to cancer genetics; only 59% (95% CI 51-67%) of the study sample had documentation of referral following their diagnosis. This suggests a general unmet need to further educate providers on the importance of referral for genetics evaluation in the context of ovarian cancer. Of the four patient characteristics studied, ethnicity, insurance type and age at diagnosis were not found to be statistically significant potential predictors for genetics referral. Patients with “unknown” stage at diagnosis had a lower percent of documented referral than patients with known stage cancer. Further research is needed to identify why a significant proportion of women with ovarian cancer are not being referred for genetics evaluation.
*National Comprehensive Cancer Network 2014.