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Most Patients with Colorectal Tumors at Young Age Do Not Visit a Cancer Genetics Clinic

Radboud University Nijmegen Medical Center Department of Human Genetics Nijmegen Netherlands; Radboud University Nijmegen Medical Center Department of Medical Oncology Nijmegen Netherlands
Diseases of the Colon & Rectum (Impact Factor: 3.34). 01/2008; 51(8):1249-1254. DOI:10.1007/s10350-008-9345-x
Source: PubMed

ABSTRACT PurposeThis study examined the referral process for genetic counseling at a cancer genetics clinic in patients with colorectal cancer
and to search for determinants of variation in this referral process.

MethodsPatients who were recently diagnosed with colorectal cancer at a young age or multiple cancers associated with Lynch syndrome,
hereditary nonpolyposis colorectal cancer, (N = 119) were selected from PALGA, the nationwide network and registry of histopathology
and cytopathology in the Netherlands. In a retrospective analysis, we examined whether these patients visited a cancer genetics
clinic and identified determinants for referral to such a clinic. Factors of patients, professional practice, and hospital
setting were explored with logistic regression modeling.

ResultsThirty-six (30 percent) patients visited a cancer genetics clinic. Seventy percent of patients whom the surgeon referred to
a cancer genetics clinic decided to visit such a clinic. Analysis of determinants showed that patients with whom the surgeon
discussed referral and that were treated in a teaching hospital were more likely to visit a cancer genetics clinic.

ConclusionThe referral process is not optimally carried out. To deliver optimal care for patients suspected of hereditary colorectal
cancer, this process must be improved with interventions focusing on patient referral by surgeons and raising awareness in
nonteaching hospitals.

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