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ABSTRACT: Background
Genetic counseling by a Genetic Counselor (GC) is a requirement prior to genetic testing for cancer susceptibility genes (GC-mandate policy) for some insurers. This study evaluated the impact of this policy from the patient perspective.Methods
Surveys were sent to individuals for whom their insurer ordered genetic testing for the cancer susceptibility genes BCRA1 and BRCA2 over a 1 year time period that spanned the introduction of a GC-mandate policy. Responses were assessed by time period (before/after policy introduction) and genetic test completion.Results
The surveys were completed by 1247/4950 (25.7%) eligible individuals. After policy introduction, there was no change in the proportion of respondents who completed genetic testing (p?=?0.13) or had a mutation (p?=?0.55). Overall decisional conflict (uncertainty or feeling uninformed) around genetic testing did not change after policy introduction (p?=?0.16), but was significantly higher among respondents who did not complete genetic testing (p?ConclusionsA GC-mandate policy did not improve decisional conflict or increase the number of deleterious mutations identified and low-income respondents were less likely to complete testing. On the contrary, insurance requirements and time constraints may be preventing individuals at risk from receiving appropriate testing.
SUBMITTER: Stenehjem DD
PROVIDER: S-EPMC5842549 | biostudies-literature | 2018 Mar
REPOSITORIES: biostudies-literature
Stenehjem David D DD Au Trang T Sainski Amy M AM Bauer Hillevi H Brown Krystal K Lancaster Johnathan J Stevens Vanessa V Brixner Diana I DI
BMC health services research 20180307 1
<h4>Background</h4>Genetic counseling by a Genetic Counselor (GC) is a requirement prior to genetic testing for cancer susceptibility genes (GC-mandate policy) for some insurers. This study evaluated the impact of this policy from the patient perspective.<h4>Methods</h4>Surveys were sent to individuals for whom their insurer ordered genetic testing for the cancer susceptibility genes BCRA1 and BRCA2 over a 1 year time period that spanned the introduction of a GC-mandate policy. Responses were as ...[more]