In a study reported in the Journal of Clinical Oncology, Anita Y. Kinney, PhD, RN, and colleagues found that a phone-based tailored risk counseling and navigation intervention resulted in a higher proportion of patients with ovarian or high-risk breast cancers receiving cancer genetic risk assessment compared with a mailed targeted print education intervention or usual care.
As stated by the investigators, “Cancer genetic risk assessment is recommended for [patients] with ovarian cancer or high-risk breast cancer, yet fewer than 30% receive recommended genetic services, with the lowest rates among underserved populations.”
Anita Y. Kinney, PhD, RN
In the trial, 641 patients with ovarian or high-risk breast cancer from statewide cancer registries in Colorado, New Jersey, and New Mexico were randomly assigned 1:1:1 to participate in the phone-based tailored risk counseling and navigation intervention (n = 212), the mailed targeted print intervention (n = 216), or usual care (n = 213). Patients in the phone-based tailored risk counseling and navigation intervention group received a mailed educational brochure, an initial phone-based psychoeducational session with a health coach, a follow-up letter, and a follow-up navigation phone call; patients in the targeted print group received the mailed educational brochure. Overall, 25.4% of patients identified as Hispanic and 5.9% as non-Hispanic Black; 17.5% lived in rural areas.
At 6 months, 18.7% of patients in the phone-based tailored risk counseling and navigation intervention group had received medically verified cancer genetic risk assessment—significantly higher rates than the mailed targeted print group (3.0%; odds ratio [OR] = 7.4, 95% confidence interval [CI] = 3.0–18.3, P < .0001) and the usual care group (2.5%; OR = 8.9, 95% CI = 3.4–23.5, P < .0001). There was no significant difference in cancer genetic risk assessment uptake for the mailed targeted print group vs the usual care group (OR = 1.2, 95% CI = 0.4–4.0, P = .767).
Among the total of 43 women who underwent medically verified cancer genetic risk assessment, 65% had both counseling and testing, 24% had testing only, and 12% had counseling only.
The most frequently cited barriers to counseling were lack of provider referral (33.7%) and cost concerns (26.5%). The most frequently cited barriers to testing were cost concerns (41.2%) and anticipated challenges in coping with results (14.0%).
The investigators concluded: “[A] phone-based tailored risk counseling and navigation intervention increased cancer genetic risk assessment uptake in a group of geographically and ethnically diverse high-risk breast and ovarian cancer survivors. Remote personalized interventions that incorporate evidence-based health communication and behavior change strategies may increase cancer genetic risk assessment among [patients] recruited from statewide cancer registries.”
Dr. Kinney, of Rutgers Cancer Institute of New Jersey, New Brunswick, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the National Cancer Institute and others. For full disclosures of the study authors, visit ascopubs.org.The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.