Impact of the 2014 NCCN guidelines for genetic testing on an academic gynecologic oncology practice

OBJECTIVE: To determine the impact the change in NCCN guidelines for genetic counseling had on an academic Gynecologic Oncology practice. Further, to evaluate the patients being referred and the effectiveness of the genetic counseling referral process for ovarian cancer patients. DESIGN: A retrospective medical chart review was conducted of new ovarian cancer patients seen prior to (n=144) and following (n=173) the change in guidelines. Data such as cancer diagnosis, age at diagnosis, cancer family history, referral for genetic counseling, genetic counseling date, and genetic testing type was collected. Data was coded and analyzed using descriptive statistics and SPSS to determine if there was a statistically significant change before and after the guidelines publication. RESULTS: The referral rate for genetic counseling from January-March 2013 was determined to be 52% and in 2014 was 83.3%. This showed a 31.3% increase in genetic counseling referrals (p=.019). However, there were still patients not being referred and some patients did not have complete genetic testing. DISCUSSION: The change in NCCN guidelines did have an impact on patient care in this academic gynecologic oncology clinic. An effective referral system needs to be set up not only for new patients, but also for established patients who never had genetic testing or had incomplete testing