Cancers, Vol. 17, Pages 1154: Implementation of a Traceback Testing Program for Ovarian Cancer: Findings from the FACTS Study

Cancers doi: 10.3390/cancers17071154

Authors:
Nora B. Henrikson
M. Cabell Jonas
Paula R. Blasi
Adam H. Buchanan
Pim Suwannarat
Kathleen Leppig
Aaron Scrol
Tracey Leitzel
Adrienne N. Deneal
Daniela Canedo
Arvind Ramaprasan
Sundeep S. Basra
Jennifer Brown
Marilyn Odums
Yirui Hu
Katrina M. Romagnoli
Estella Khieu
Elsa Balton
Saumya Patel
Muki Kunnmann
Dina Hassen
Jing Hao
Meredith Lewis
Rachel Schwiter
Jessica Goehringer
Heather M. Ramey
Shanshan Gustafson
Katrina Hsieh
Ilene Ladd
Alanna K. Rahm

Background: Traceback testing—identifying and offering testing to people with previous cancer diagnoses who have not received current standard genetic testing—could benefit patients and their at-risk relatives. Methods: We conducted a multisite, nonrandomized pilot implementation study of a Traceback program at three integrated United States health systems. We assessed the reach, fidelity, effectiveness, and acceptability of the program using quantitative and qualitative methods. Results: We identified 597 eligible individuals using administrative data and manual chart review. We attempted to reach everyone identified (100% fidelity). We successfully contacted 354 people, for a reach of 59% of confirmed eligible individuals. In total, 133 people completed Traceback genetic testing. Ten of these (8%) received pathogenic or likely pathogenic results;. Nine of these ten people received positive results for which cascade testing of at-risk relatives would be indicated. None of their relatives underwent cascade testing during the study period. Thirty-six received variants of uncertain significance (VUS). Traceback programs were acceptable to participants and implementers and thought to be applicable to other genetic screening conditions. The time and resources required to accurately identify Traceback-eligible individuals are likely determinants of future sustainability. Conclusions: Education about free cascade testing, reminder calls to probands, and offers to directly contact at-risk relatives did not result in cascade testing in this pilot study. However, participant and implementer discussions suggest that the potential benefits of Traceback programs and high participant acceptability are worthy of further study.

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Nora B. Henrikson www.mdpi.com