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Stakeholders’ views of integrating universal tumour screening and genetic testing for colorectal and endometrial cancer into routine oncology

European Journal of Human Genetics volume 29, pages 1634–1644 (2021)Cite this article

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Abstract

Mainstream genetic testing in routine oncology care requires implementation research to inform intervention design. In Australia, funding is available for oncology health professionals (OHP) to organise genetic testing (GT) for eligible colorectal and endometrial cancer patients as part of their routine care. To assess the health system ability to incorporate this practice change, we conducted an implementation survey using the Consolidated Framework for Implementation Research (CFIR). The online survey was available from April to September 2020 to OHP and genetic health professional (GHP). In total, 198 respondents attempted the survey, with 158 completed and 27 partial responses: 26% were GHP, 66% OHP and 8% pathologists. Of all responders, 50% were female, mainly practicing in public hospital settings (57%) in an urban location (80%) and with an 18–60 years plus age range. The majority of respondents saw the relative advantage of aligning GT to abnormal universal tumour screening (UTS) results, with 77% of GHP and 78% of OHP agreeing it would streamline care for patients. There was disagreement across healthcare professional groups about knowledge and self-efficacy, with 45% of GHP not viewing oncologists as ‘feeling confident’ to use genetic test results for treatment management decisions, while 62% of OHP felt confident in their ability. Both OHP and GHP’s indicated embedding a genetic counsellor in oncology or having a genetics point of contact to support integrating of GT through UTS as favourable interventions. Implementation research findings allow for the design of targeted interventions and a model for GT integration into oncology.

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Fig. 1: Demographics of total respondents.
Fig. 2: System barriers identified for mainstreaming genetic testing.

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Authors and Affiliations

  1. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

    Rosie O’Shea, Nicole M. Rankin, Natalie Taylor & Sarah Lewis

  2. Discipline of Genetic Counselling, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia

    Rosie O’Shea

  3. Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia

    Maira Kentwell

  4. Department of Oncology, Royal Women’s Hospital Parkville, Melbourne, VIC, Australia

    Maira Kentwell

  5. Hunter Family Cancer Service, Newcastle, NSW, Australia

    Margaret Gleeson

  6. Hereditary Cancer Clinic, Prince of Wales Hospital, Sydney, NSW, Australia

    Katherine M. Tucker

  7. Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA

    Heather Hampel

  8. Cancer Research Division, Cancer Council, Sydney, NSW, Australia

    Natalie Taylor

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Correspondence to Rosie O’Shea.

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O’Shea, R., Rankin, N.M., Kentwell, M. et al. Stakeholders’ views of integrating universal tumour screening and genetic testing for colorectal and endometrial cancer into routine oncology. Eur J Hum Genet 29, 1634–1644 (2021). https://doi.org/10.1038/s41431-021-00871-4

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