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“Game Changer”: Health Professionals’ Views on the Clinical Utility of Circulating Tumor DNA Testing in Hereditary Cancer Syndrome Management

BACKGROUND: We explored health professionals’ views on the utility of circulating tumor DNA (ctDNA) testing in hereditary cancer syndrome (HCS) management. MATERIALS AND METHODS: A qualitative interpretive description study was conducted, using semi-structured interviews with professionals across Ca...

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Autores principales: Shickh, Salma, Oldfield, Leslie E, Clausen, Marc, Mighton, Chloe, Sebastian, Agnes, Calvo, Alessia, Baxter, Nancy N, Dawson, Lesa, Penney, Lynette S, Foulkes, William, Basik, Mark, Sun, Sophie, Schrader, Kasmintan A, Regier, Dean A, Karsan, Aly, Pollett, Aaron, Pugh, Trevor J, Kim, Raymond H, Bombard, Yvonne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075003/
https://www.ncbi.nlm.nih.gov/pubmed/35385106
http://dx.doi.org/10.1093/oncolo/oyac039
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author Shickh, Salma
Oldfield, Leslie E
Clausen, Marc
Mighton, Chloe
Sebastian, Agnes
Calvo, Alessia
Baxter, Nancy N
Dawson, Lesa
Penney, Lynette S
Foulkes, William
Basik, Mark
Sun, Sophie
Schrader, Kasmintan A
Regier, Dean A
Karsan, Aly
Pollett, Aaron
Pugh, Trevor J
Kim, Raymond H
Bombard, Yvonne
author_facet Shickh, Salma
Oldfield, Leslie E
Clausen, Marc
Mighton, Chloe
Sebastian, Agnes
Calvo, Alessia
Baxter, Nancy N
Dawson, Lesa
Penney, Lynette S
Foulkes, William
Basik, Mark
Sun, Sophie
Schrader, Kasmintan A
Regier, Dean A
Karsan, Aly
Pollett, Aaron
Pugh, Trevor J
Kim, Raymond H
Bombard, Yvonne
author_sort Shickh, Salma
collection PubMed
description BACKGROUND: We explored health professionals’ views on the utility of circulating tumor DNA (ctDNA) testing in hereditary cancer syndrome (HCS) management. MATERIALS AND METHODS: A qualitative interpretive description study was conducted, using semi-structured interviews with professionals across Canada. Thematic analysis employing constant comparison was used for analysis. 2 investigators coded each transcript. Differences were reconciled through discussion and the codebook was modified as new codes and themes emerged from the data. RESULTS: Thirty-five professionals participated and included genetic counselors (n = 12), geneticists (n = 9), oncologists (n = 4), family doctors (n = 3), lab directors and scientists (n = 3), a health-system decision maker, a surgeon, a pathologist, and a nurse. Professionals described ctDNA as “transformative” and a “game-changer”. However, they were divided on its use in HCS management, with some being optimistic (optimists) while others were hesitant (pessimists). Differences were driven by views on 3 factors: (1) clinical utility, (2) ctDNA’s role in cancer screening, and (3) ctDNA’s invasiveness. Optimists anticipated ctDNA testing would have clinical utility for HCS patients, its role would be akin to a diagnostic test and would be less invasive than standard screening (eg imaging). Pessimistic participants felt ctDNA testing would add limited utility; it would effectively be another screening test in the pathway, likely triggering additional investigations downstream, thereby increasing invasiveness. CONCLUSIONS: Providers anticipated ctDNA testing will transform early cancer detection for HCS families. However, the contrasting positions on ctDNA’s role in the care pathway raise potential practice variations, highlighting a need to develop evidence to support clinical implementation and guidelines to standardize adoption.
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spelling pubmed-90750032022-05-09 “Game Changer”: Health Professionals’ Views on the Clinical Utility of Circulating Tumor DNA Testing in Hereditary Cancer Syndrome Management Shickh, Salma Oldfield, Leslie E Clausen, Marc Mighton, Chloe Sebastian, Agnes Calvo, Alessia Baxter, Nancy N Dawson, Lesa Penney, Lynette S Foulkes, William Basik, Mark Sun, Sophie Schrader, Kasmintan A Regier, Dean A Karsan, Aly Pollett, Aaron Pugh, Trevor J Kim, Raymond H Bombard, Yvonne Oncologist Health Outcomes and Economics of Cancer Care BACKGROUND: We explored health professionals’ views on the utility of circulating tumor DNA (ctDNA) testing in hereditary cancer syndrome (HCS) management. MATERIALS AND METHODS: A qualitative interpretive description study was conducted, using semi-structured interviews with professionals across Canada. Thematic analysis employing constant comparison was used for analysis. 2 investigators coded each transcript. Differences were reconciled through discussion and the codebook was modified as new codes and themes emerged from the data. RESULTS: Thirty-five professionals participated and included genetic counselors (n = 12), geneticists (n = 9), oncologists (n = 4), family doctors (n = 3), lab directors and scientists (n = 3), a health-system decision maker, a surgeon, a pathologist, and a nurse. Professionals described ctDNA as “transformative” and a “game-changer”. However, they were divided on its use in HCS management, with some being optimistic (optimists) while others were hesitant (pessimists). Differences were driven by views on 3 factors: (1) clinical utility, (2) ctDNA’s role in cancer screening, and (3) ctDNA’s invasiveness. Optimists anticipated ctDNA testing would have clinical utility for HCS patients, its role would be akin to a diagnostic test and would be less invasive than standard screening (eg imaging). Pessimistic participants felt ctDNA testing would add limited utility; it would effectively be another screening test in the pathway, likely triggering additional investigations downstream, thereby increasing invasiveness. CONCLUSIONS: Providers anticipated ctDNA testing will transform early cancer detection for HCS families. However, the contrasting positions on ctDNA’s role in the care pathway raise potential practice variations, highlighting a need to develop evidence to support clinical implementation and guidelines to standardize adoption. Oxford University Press 2022-04-06 /pmc/articles/PMC9075003/ /pubmed/35385106 http://dx.doi.org/10.1093/oncolo/oyac039 Text en © The Author(s) 2022. Published by Oxford University Press. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com.
spellingShingle Health Outcomes and Economics of Cancer Care
Shickh, Salma
Oldfield, Leslie E
Clausen, Marc
Mighton, Chloe
Sebastian, Agnes
Calvo, Alessia
Baxter, Nancy N
Dawson, Lesa
Penney, Lynette S
Foulkes, William
Basik, Mark
Sun, Sophie
Schrader, Kasmintan A
Regier, Dean A
Karsan, Aly
Pollett, Aaron
Pugh, Trevor J
Kim, Raymond H
Bombard, Yvonne
“Game Changer”: Health Professionals’ Views on the Clinical Utility of Circulating Tumor DNA Testing in Hereditary Cancer Syndrome Management
title “Game Changer”: Health Professionals’ Views on the Clinical Utility of Circulating Tumor DNA Testing in Hereditary Cancer Syndrome Management
title_full “Game Changer”: Health Professionals’ Views on the Clinical Utility of Circulating Tumor DNA Testing in Hereditary Cancer Syndrome Management
title_fullStr “Game Changer”: Health Professionals’ Views on the Clinical Utility of Circulating Tumor DNA Testing in Hereditary Cancer Syndrome Management
title_full_unstemmed “Game Changer”: Health Professionals’ Views on the Clinical Utility of Circulating Tumor DNA Testing in Hereditary Cancer Syndrome Management
title_short “Game Changer”: Health Professionals’ Views on the Clinical Utility of Circulating Tumor DNA Testing in Hereditary Cancer Syndrome Management
title_sort “game changer”: health professionals’ views on the clinical utility of circulating tumor dna testing in hereditary cancer syndrome management
topic Health Outcomes and Economics of Cancer Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075003/
https://www.ncbi.nlm.nih.gov/pubmed/35385106
http://dx.doi.org/10.1093/oncolo/oyac039
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