ReCAP: Oncologists Selection of Genetic and Molecular Testing in the Evolving Landscape of Stage II Colorectal Cancer [FOCUS ON QUALITY]

In this study, we asked: how does the family history of patients with stage II CRC influence medical oncologists’ selection of genetic and molecular testing, both related and unrelated to Lynch syndrome? SUMMARY ANSWER: We found that oncologists’ self-reported ordering of Lynch syndrome–related tests was strongly associated with the strength of CRC family history, but even so, not all oncologists would order germline testing for mismatch repair (MMR) genes, much less screen for Lynch syndrome by ordering microsatellite instability and/or immunohistochemistry for MMR proteins, in a patient scenario with the strongest family history of CRC (Table 2). We also found overtesting of KRAS and Oncotype DX for stage II CRC associated with certain practice and provider characteristics, with graduates of non-US or non-Canadian medical schools and physicians compensated under fee-for-service or by productivity-based salaries being more likely to choose KRAS testing. Fee-for-service and productivity-based salaries were also associated with increased Oncotype DX testing. Table 2.Percentages of Oncologists Who Reported They Would Order Genetic and Molecular Testing for a Patient Newly Diagnosed With Stage II CRC, Unadjusted TestOverall, No. (%)Clinical Scenario*No Family History, % (n = 109)Weak Family History,% (n = 103)Strong Family History, % (n = 109)PIndividual Germline143 (45)163287< .001 MSI and/or IHC for MMR proteins205 (64)535882< .001 BR...
Source: Journal of Oncology Practice - Category: Cancer & Oncology Authors: Tags: Clinical guidelines, Quality, Epidemiology, Diagnosis & Staging, Quality of Care, Adult Medical Oncology FOCUS ON QUALITY Source Type: research