Errors in delivery of cancer genetics services: implications for practice
Karina L Brierley1, Danielle Campfield, Whitney Ducaine
1Yale Cancer Center, Yale University School of Medicine, New Haven, CT 06510, USA.
Connecticut Medicine
|September 2, 2010
Summary
Genetic testing for cancer can lead to negative outcomes if not performed with proper genetic counseling. Ensuring qualified professionals handle genetic counseling and testing is crucial for patient safety and appropriate medical management.
Area of Science:
- Medical Genetics
- Oncology
- Healthcare Policy
Background:
- Genetic testing and counseling are increasingly recommended for healthcare providers.
- Concerns exist regarding negative outcomes from cancer genetic testing without certified genetics professionals.
- A national series of cases highlights issues with genetic testing performed without qualified counseling.
Purpose of the Study:
- To illustrate negative outcomes of cancer genetic testing performed without qualified counseling.
- To identify patterns of failure in the process of cancer genetic testing and counseling.
- To inform best practices for genetic counseling and testing in oncology.
Main Methods:
- Analysis of a national series of cases involving cancer genetic testing.
- Identification of common patterns leading to negative outcomes.
- Review of clinical management and patient experiences.
Main Results:
- Three major patterns of negative outcomes were identified: wrong test ordered, misinterpreted results, and inadequate counseling.
- Negative outcomes included unnecessary surgeries, further testing, psychosocial distress, and false reassurance.
- Inappropriate medical management resulted from inadequate or incorrect genetic information.
Conclusions:
- The complexity of cancer genetic counseling and testing makes it challenging for all clinicians to provide these services.
- A more realistic approach involves enhanced provider education and clear referral pathways.
- Healthcare providers should identify patients benefiting from referral to certified genetic counselors or experienced cancer genetics professionals.
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