Aitken Lucy, Warwick Linda, Davis Alison
Australian National University, Canberra, Australian Capital Territory, Australia.
ACT Genetic Service, The Canberra Hospital, Canberra, Australian Capital Territory, Australia.
Intern Med J. 2017 Mar;47(3):311-317. doi: 10.1111/imj.13357.
The ACT Genetic Service at The Canberra Hospital evaluates the genetic risk of individuals for inherited diseases, and provides counselling and genetic testing where appropriate.
To evaluate the current referral practice for patients with a personal and/or family history of breast and/or ovarian cancer, and to assess whether these referrals are made according to eviQ cancer referral guidelines.
A retrospective clinical audit of patients seen by the ACT Genetic Service for evaluation of genetic risk of breast and/or ovarian cancer between 1 January 2013 and 30 June 2015. Statistical analysis included Chi-squared and Poisson distribution tests.
Of the 711 patients referred during the 30-month period, 671 were seen by the service. The number of patients seen increased steadily over the time period, as did waiting times. The majority of referrals were made by general practitioners (403/711; 57%) and oncologists (172/711; 24%). Of note, 300 of 711 (42%) of all referrals made to the service during this time period did not meet eviQ referral guidelines. Patients who met guidelines for referral were more likely both to be offered genetic testing and to have a positive result.
Demand on the ACT Genetic Service increased over the time period assessed. As a significant proportion of patients did not meet eviQ cancer referral guidelines, it is worth reviewing the referral process in order to optimise utility of this limited resource.
堪培拉医院的ACT基因服务中心评估个体患遗传性疾病的基因风险,并在适当情况下提供咨询和基因检测。
评估目前针对有乳腺癌和/或卵巢癌个人和/或家族病史患者的转诊实践,并评估这些转诊是否符合eviQ癌症转诊指南。
对2013年1月1日至2015年6月30日期间由ACT基因服务中心诊治以评估乳腺癌和/或卵巢癌基因风险的患者进行回顾性临床审计。统计分析包括卡方检验和泊松分布检验。
在30个月期间转诊的711名患者中,该服务中心诊治了671名。在此期间,诊治的患者数量和等待时间均稳步增加。大多数转诊由全科医生(403/711;57%)和肿瘤学家(172/711;24%)提出。值得注意的是,在此期间转诊至该服务中心的所有711名患者中,有300名(42%)不符合eviQ转诊指南。符合转诊指南的患者更有可能接受基因检测且检测结果呈阳性。
在所评估的时间段内,对ACT基因服务中心的需求有所增加。由于相当一部分患者不符合eviQ癌症转诊指南,因此值得对转诊流程进行审查,以优化这一有限资源的效用。