A framework to build capacity for a reflex-testing program for Lynch syndrome.

Area of Science:

• Oncology
• Genetics
• Public Health

Background:

• Lynch syndrome (LS) is a primary inherited cause of colorectal cancer.
• Despite recommendations, widespread adoption of LS reflex testing in health systems is lacking.
• This study focuses on designing a provincial reflex testing program in Ontario, Canada.

Purpose of the Study:

• To explore barriers and facilitators for implementing a Lynch syndrome reflex testing program.
• To develop a framework for a population-level reflex testing initiative.
• To refine the program framework and identify recommendations through stakeholder engagement.

Main Methods:

• Qualitative interviews with key stakeholders were conducted.
• Iterative data analysis identified key themes.
• A program framework was developed and refined with stakeholder input.

Main Results:

• Key themes included the need for stakeholder education (patients, providers, surgeons).
• Identified challenges involved sustaining resources like laboratory costs and pathologist workload.
• Ensuring consistent reporting and developing success metrics were crucial.

Conclusions:

• This research identifies critical factors for effective population-level Lynch syndrome reflex testing.
• A prototype framework is presented for implementation in other regions, adaptable to local contexts.