Disparities between Uptake of Germline / Gene Tests and Implementation of Post-test Management Strategies in Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer Patients.

BACKGROUND

To assess the rate of germline gene tests in epithelial ovarian cancer (EOC) patients and uptake of post-test risk management strategies in /-mutated patients.

METHODS

Institutional databases were searched to identify patients who were diagnosed with epithelial ovarian, fallopian tube, or primary peritoneal cancer (EOC) between 2009 and 2019 in two academic hospitals. Retrospective review on medical records was performed to collect clinico-pathologic variables, including performance of germline gene test and its results, as well as conduct of breast cancer screening tests and cascade testing. If annual mammography +/- breast ultrasonography was performed, it was considered that regular breast cancer surveillance was done.

RESULTS

A total of 840 women with EOC were identified during the study period. Of these, 454 patients (54.0%) received gene testing and 106 patients (106/454, 23.3%) were positive for mutations. The rate of tests has markedly increased from 25.8% in 2009-2012 to 62.7% in 2017-2019. Among the 93 patients with mutation without previous personal breast cancer history, 20 patients (21.5%) received annual mammography with or without breast ultrasonography for regular surveillance. Among the 106 -mutated EOC patients, cascade testing on family members was performed only in 13 patients (12.3%).

CONCLUSION

Although gene tests have been substantially expanded, the uptake of post-test risk management strategies, including breast cancer screening for -mutated patients and cascade testing for family members, has remained low. Strategies to increase its uptake and education about the importance of post-test risk managements are needed.