Abstract
Background
Prostate cancer (PCA) germline testing (GT) is now standard-of-care for men with advanced
PCA. Thousands of men may consider GT due to clinical and family history (FH) features.
Identifying and consenting men for GT can be complex. Here we identified barriers
and facilitators of GT across a spectrum of providers which informed the development
of Helix – an educational and clinical/FH collection tool to facilitate GT in practice.
Materials and Methods
A 12-question survey assessing knowledge of genetics PCA risk and FH was administered
December 2017 to March 2018 in the Philadelphia area and at the Mid-Atlantic AUA meeting
(March 2018). Responses were analyzed using descriptive statistics. Semi-structured
interviews were conducted with medical oncologists, radiation oncologists, and urologists
across practice settings from March-October 2020 as part of a larger study based on
the Tailored Implementation in Chronic Diseases framework. Helix was then developed
followed by user testing.
Results
Fifty-six providers (50% urologists) responded to the survey. Multiple FH and genetic
knowledge gaps were identified: only 66% collected maternal FH and 43% correctly identified
BRCA2 and association to aggressive PCA. Genetic counseling gaps included low rates of
discussing genetic discrimination laws (45%). Provider interviews (n = 14) identified
barriers to FH intake including access to details and time needed. In user testing
(n = 10), providers found Helix helpful for FH collection. All providers found Helix
easy to use, suggesting expanded clinical use.
Conclusion
Helix addressed multiple GT knowledge and practice gaps across a spectrum of providers.
This tool will become publicly available soon to facilitate PCA GT in clinical practice.
Keywords
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Article info
Publication history
Published online: November 26, 2021
Accepted:
November 21,
2021
Received:
August 6,
2021
Identification
Copyright
© 2021 Published by Elsevier Inc.
