Who is being referred to cancer genetic counseling? Characteristics of counselees and their referral
- PDF / 652,956 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 39 Downloads / 167 Views
ORIGINAL ARTICLE
Who is being referred to cancer genetic counseling? Characteristics of counselees and their referral E. van Riel & S. van Dulmen & M. G. E. M. Ausems
Received: 16 June 2011 / Accepted: 6 March 2012 / Published online: 17 March 2012 # Springer-Verlag 2012
Abstract Both physician and patient play a role in the referral process for cancer genetic counseling. Access to such counseling is not optimal because some eligible patients are not being reached by current referral practice. We aimed to identify factors associated with the initiator of referral. During a 7-month period, we recorded demographic characteristics like gender, personal and family history of cancer, ethnicity and eligibility for genetic testing for 406 consecutive counselees using a specially designed questionnaire. Counselees were seen in a university hospital or a community hospital (n 07) in the Netherlands. We also recorded educational level of each counselee, clinical setting and who initiated referral. Descriptive statistics were used to describe the counselees’ general characteristics. We analysed the association between counselee characteristics and the initiator of referral by logistic regression. The majority of counselees seemed to have initiated referral themselves but were indeed eligible for genetic testing. In comparison to the general population in the Netherlands, the counselees had a higher level of education, and there were fewer immigrants, although a higher level of education was not found to be a facilitating factor for referral. The clinical setting where a counselee was seen was associated with initiator of referral, although this relationship was not straightforward. There E. van Riel (*) : M. G. E. M. Ausems Department of Medical Genetics, University Medical Centre Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands e-mail: [email protected] S. van Dulmen Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
is a complex interaction between clinical setting and initiator of referral, which warrants further research to elucidate the factors involved in this relationship. Patients seen in cancer genetic counseling do not reflect the general population in terms of educational level or ethnicity. Keywords Cancer genetic counseling . Initiative . Referral process . Education . Accessibility
Introduction Cancer genetic counseling is increasingly being offered to patients who have cancer and/or to their healthy relatives. In the Netherlands, genetic counseling is covered by compulsory health insurance and is therefore available to all patients, who must be referred to a family cancer clinic by a physician [general practitioner (GP) or medical specialist]. However, physicians often feel they lack sufficient knowledge to select patients eligible for cancer genetic counseling correctly (Ardern-Jones et al. 2005; McCann et al. 2005; Nippert et al. 2011), or they may desist from bringing up subjects like family history, genetic testing and hereditary cancer and only discuss th
Data Loading...
