FROM THE JOURNAL OF CLINICAL ONCOLOGY
Genetic counseling by telephone was noninferior to in-person counseling among women at increased risk of hereditary breast and/or ovarian cancer (HBOC) for all psychosocial, decision-making, and quality-of-life measures, investigators found.
In addition, genetic testing was more common among women who received in-person counseling and women who lived in rural settings.
“This trial provides important evidence that telephone genetic counseling for HBOC is noninferior to in-person counseling and can be delivered as safely as in-person counseling without an adverse effect on long-term psychological, quality-of-life, and decision-making outcomes,” according to Anita Kinney, Ph.D., of the University of New Mexico, Albuquerque, and her associates (J Clin Oncol. 2016 Jun. doi: 10.1200/JCO.2015.65.9557).
Investigators used the Utah Population Database and Utah Cancer Registry to identify breast and ovarian cancer survivors and their at-risk female relatives with deleterious BRCA 1/2 mutations. Of the 988 women who met study requirements, 495 were randomly assigned to receive in-person genetic counseling, and 493 women were assigned to receive genetic counseling via telephone. All patients received counseling by a certified cancer genetic counselor according to standardized national protocols. Importantly, there were no significant differences in age, race/ethnicity, marital status, education level, rural vs. urban residence, income, employment status or health care coverage between the two study arms.
At the 1-year follow-up, there was no significant difference between patients receiving in-person or telephone counseling for all psychosocial and informed decision-making outcomes which included anxiety (average brief symptom inventory scores, 2.37 vs. 2.74), cancer-specific distress (average impact of event scores, 10.06 vs. 11.19), quality-of-life for physical health (average short form health survey scores, 50.54 vs. 49.75), quality-of-life for mental health (50.51 vs. 50.74), decisional conflict (average decisional conflict score, 26.88 vs. 26.76), decisional regret (average decision regret score, 21.38 vs. 21.07), and perceived personal control (average questionnaire scores, 1.53 vs. 1.52).
Genetic testing was more common among women who received in-person counseling (37.3% vs. 27.9%; 95% confidence interval comparing difference in testing uptake, 2.2%-16.8%). Interestingly, testing was higher for rural, compared with urban residents, for both telephone and in-person counseling.
This study received funding from the National Institutes of Health, the Huntsman Cancer Foundation, the University of New Mexico Comprehensive Cancer Center, and the University of Utah. Twelve of the investigators had no disclosures to report. Two investigators reported serving in advisory roles or receiving honoraria from Myriad Genetics or In Vitae.
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