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Improving Access to Hereditary Cancer Risk Assessments
Current methods to enhance access to hereditary cancer risk assessments in primary care are insufficient. This study explores two strategies to identify patients with cancer histories and offer genetic testing.
Study Overview
The EDGE clinical trial involved 12 clinics across Montana, Wyoming, and Washington, engaging a total of 95,623 patients aged 25 and older who had primary care visits between April 2021 and March 2022.
Engagement Strategies
Two approaches were tested:
- Point of Care (POC): Conducted by staff just before clinical appointments.
- Direct Patient Engagement (DPE): Involves letters and emails for patients to complete assessments at home.
Patients who met the criteria were offered free genetic testing using a saliva kit delivered to their home.
Main Findings
Over the study period:
- 13,705 patients completed the risk assessment.
- POC resulted in more patients completing the assessment (19.1% vs. 8.7%).
- The completion rates for genetic testing were similar between both approaches (1.5% for POC and 1.6% for DPE).
- Among eligible patients, fewer POC patients completed testing compared to DPE (24.7% vs. 44.7%).
- Fewer actionable genetic variants were found using the POC method (3.8% vs. 6.6%).
Conclusions
The POC approach led to higher assessment rates, but the DPE approach was more effective for completing tests and identifying actionable results. A combination of both strategies may provide the best outcomes.
Opportunities for Improvement
Based on the trial results, clinics can:
- Set clear goals for patient engagement and risk assessment.
- Use AI tools tailored to specific clinical needs.
- Implement pilot projects to track outcomes and expand successful strategies.
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