Genetic assessment wait time indicators in the High Risk Ontario Breast Screening Program

Area of Science:

• Oncology
• Genetics
• Public Health

Background:

• The Ontario Breast Screening Program (OBSP) expanded in 2011 to include annual MRI and mammography for high-risk women aged 30-69.
• This study focuses on evaluating wait time (WT) indicators within the genetic assessment (GA) pathway for women referred to the High Risk OBSP.

Purpose of the Study:

• To evaluate wait time indicators along the genetic assessment pathway for women referred to the High Risk Ontario Breast Screening Program (OBSP).
• To identify factors influencing wait times for genetic assessment in high-risk women.

Main Methods:

• Data collected for 27,170 women referred to the High Risk OBSP between July 2011 and June 2015.
• Median duration (days) and interquartile range (IQR) were measured for each WT indicator, stratified by program year, age, prior breast cancer, and risk criteria.
• Follow-up for GA was conducted until June 2016.

Main Results:

• Among 24,811 women who completed GA, 66.0% had genetic counseling only, and 34.0% had counseling and testing.
• Median WT from physician visit to first screen was longer for women with counseling only (244 days) versus counseling and testing (197 days).
• Wait times to genetic counseling decreased over time and were shortest for mutation carriers (39 days).

Conclusions:

• Women received timely genetic counseling after the High Risk OBSP implementation, particularly those undergoing counseling and testing.
• Effective physician triage models may further reduce wait times to genetic assessment after referral.
• The study highlights the efficiency of the High Risk OBSP in managing genetic assessment pathways.