Abstract P3-08-03: Factors associated with genetic testing in a cohort of breast cancer survivors
Authors: Blaes AH , McKay K , Riley D , Jatoi I , Rock J , Trentham-Dietz A , Chrischilles E , Klemp J 
Published: May 2019

Background: Approximately 35% of individuals with breast cancer meet guidelines for Germline genetic testing based on young age of onset, triple-negative subtype, and positive family history. While the national guidelines expanded opportunities for genetic testing, it is unclear how consistently these guidelines are being followed. It is also unclear which factors influence the decision to receive genetic testing or learn the results of testing. We present the results of a large multi-institution survey examining factors associated with the receipt of genetic testing, adherence to recommended guidelines for genetic testing and accessing results, in addition to evaluating correlates from the medical record compared to self-report.

Methods:

The Greater Plains Collaborative (GPC) Clinical Data Research Network (CDRN) Breast Cancer Group conducted a comprehensive multi-site (7 cancer care delivery sites across the Midwest) survey, Share Thoughts on Breast Cancer Study. Inclusion criteria were women &gt;18 years, with microscopically-confirmed ductal carcinoma in situ or invasive (but not metastatic) breast cancer, diagnosed January 2013 to May 2014, and with no prior cancer other than breast cancer. Questionnaire data were linked to tumor registry data for those who consented to access their medical record.

Results:

1235/1987 surveys were completed giving an overall response rate of 61.4%. Signed informed consent to utilize medical records was obtained for 852/1235 (69%). The median age of survivors at diagnosis was 59 years, 90.4% were white, 45.2% had a 4-year college degree or more, and 58.9% had private insurance. 486/1235 (39%) underwent genetic testing with 53 planning to in the future. 8% (39) reported having a deleterious mutation with 7% not knowing the results of their genetic testing. Among younger women with no family history of breast cancer, 74.8% of those under age 50 and 89.3% of those under age 45 reported receiving genetic testing. Of younger women with &gt;1 relative with breast cancer, 86.7% (age &lt;50 years) and 87.5% (age &lt;45 years) reported receiving testing. Of those &lt; 60 years with triple negative tumors, 75.0% reported getting genetic testing. Self-reported factors that correlated with genetic testing include younger age, higher family income (54% of those with household income &gt;$100,000 were tested vs. 27% of those with household income &lt;$20,000), higher education level (49% of those with 4 years of college or more were tested vs. 25% of those with high school or less), having private insurance (53% tested, vs. 26% of those reporting government or no insurance), and having had more relatives with breast cancer.

Conclusion:

Our study demonstrates the feasibility of undertaking a comprehensive survey of breast cancer survivors from across the Midwest. Genetic testing rates of 39%, were consistent with national recommendations. However, there is still an opportunity to identify additional survivors who did not undergo testing within 2 years of their diagnosis, particularly those with lower education and poorly insured. There are ongoing efforts to determine why 7% of the cohort did not report knowing the results of their genetic testing.

Citation Format: Blaes AH, McKay K, Riley D, Jatoi I, Rock J, Trentham-Dietz A, Chrischilles E, Klemp J. Factors associated with genetic testing in a cohort of breast cancer survivors [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-08-03.