On-Site Genetic Prostate Cancer Testing Boosted Compliance

Implementation of an on-site, guideline-based genetic testing model for patients with prostate cancer significantly improved compliance with genetic testing and decreased turnaround time for results, according to a recent study published in Urology Practice.

“The identification of germline genetic mutations has significant implications for the treatment of prostate cancer,” study researchers explained. “In 2019, the revised recommendations from the Philadelphia Consensus Conference endorsed point-of-care genetic testing and referral to genetic counseling as a potential solution to increase the utilization of genetic testing.”

However, little is known about the successful implementation of strategies aimed at streamlining methods for genetic testing of this patient population. The researchers conducted this retrospective study to explore the possible benefit of an on-site, guideline-based genetic testing process.

They looked at data for 552 patients with prostate cancer seen in a uro-oncology clinic since January 2017. Before September 2018, swabs for genetic testing were procured off-site 1 mile from the clinic (78 patients). After September 2018, swabs for genetic testing were procured at the clinic (474 patients).

In 2018, the researchers introduced the comprehensive genetic testing protocol at their large urology practice. Consistent with National Comprehensive Cancer Network guidelines, patients were recommended for testing to identify mutations associated with prostate cancer based on family history of prostate cancer, hereditary breast or ovarian cancer, and Ashkenazi Jewish ancestry, among other factors. Testing was performed at routine clinic visits, with follow-up genetic counseling provided by the patient’s urologist or other clinicians.

The new protocol approximately tripled the rate of patient compliance with recommended genetic testing: from 33.3% to 98.7%. Compliance for genetic testing was 0% prior to implementation of the in-site testing and increased to 60.0% after implementation.

Point-of-care testing also decreased turnaround time to the availability of genetic test results, from 38 to 21 days.

“These results underscore the importance of a systematic model for genetic testing, and the implication on utilization and patient compliance,” the researchers wrote. “Given the growing importance of genetic testing in the management of prostate cancer in the setting of underutilization of genetic testing, these results present a solution to bolster genetic testing usage with corresponding improvements in patient compliance.”

Reference

Positive Impact of Implementing a Comprehensive Genetic Testing Protocol for Prostate Cancer Patients in a Multi-Disciplinary Uro-Oncology Practice