A mainstreaming oncogenomics model: improving the identification of Lynch syndrome
Introduction“Mainstreaming” is a proposed strategy to integrate genomic testing into oncology. The aim of this paper is to develop a mainstreaming oncogenomics model by identifying health system interventions and implementation strategies for mainstreaming Lynch syndrome genomic testing.MethodsA rig...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1140135/full |
| _version_ | 1797818774190030848 |
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| author | Rosie O’Shea Ashley Crook Chris Jacobs Maira Kentwell Maira Kentwell Margaret Gleeson Katherine M. Tucker Heather Hampel Alanna Kulchak Rahm Natalie Taylor Natalie Taylor Sarah Lewis Nicole M. Rankin Nicole M. Rankin |
| author_facet | Rosie O’Shea Ashley Crook Chris Jacobs Maira Kentwell Maira Kentwell Margaret Gleeson Katherine M. Tucker Heather Hampel Alanna Kulchak Rahm Natalie Taylor Natalie Taylor Sarah Lewis Nicole M. Rankin Nicole M. Rankin |
| author_sort | Rosie O’Shea |
| collection | DOAJ |
| description | Introduction“Mainstreaming” is a proposed strategy to integrate genomic testing into oncology. The aim of this paper is to develop a mainstreaming oncogenomics model by identifying health system interventions and implementation strategies for mainstreaming Lynch syndrome genomic testing.MethodsA rigorous theoretical approach inclusive of conducting a systematic review and qualitative and quantitative studies was undertaken using the Consolidated Framework for Implementation Research. Theory-informed implementation data were mapped to the Genomic Medicine Integrative Research framework to generate potential strategies.ResultsThe systematic review identified a lack of theory-guided health system interventions and evaluation for Lynch syndrome and other mainstreaming programs. The qualitative study phase included 22 participants from 12 health organizations. The quantitative Lynch syndrome survey included 198 responses: 26% and 66% from genetic and oncology health professionals, respectively. Studies identified the relative advantage and clinical utility of mainstreaming to improve genetic test access and to streamline care, and adaptation of current processes was recognized for results delivery and follow-up. Barriers identified included funding, infrastructure and resources, and the need for process and role delineation. The interventions to overcome barriers were as follows: embedded mainstream genetic counselors, electronic medical record genetic test ordering, results tracking, and mainstreaming education resources. Implementation evidence was connected through the Genomic Medicine Integrative Research framework resulting in a mainstreaming oncogenomics model.DiscussionThe proposed mainstreaming oncogenomics model acts as a complex intervention. It features an adaptable suite of implementation strategies to inform Lynch syndrome and other hereditary cancer service delivery. Implementation and evaluation of the model are required in future research. |
| first_indexed | 2024-03-13T09:13:00Z |
| format | Article |
| id | doaj.art-42a7b5f256154dbda012c9e160b6e65c |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-13T09:13:00Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-42a7b5f256154dbda012c9e160b6e65c2023-05-26T18:18:46ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11401351140135A mainstreaming oncogenomics model: improving the identification of Lynch syndromeRosie O’Shea0Ashley Crook1Chris Jacobs2Maira Kentwell3Maira Kentwell4Margaret Gleeson5Katherine M. Tucker6Heather Hampel7Alanna Kulchak Rahm8Natalie Taylor9Natalie Taylor10Sarah Lewis11Nicole M. Rankin12Nicole M. Rankin13Faculty of Medicine and Health, University of Sydney, Sydney, NSW, AustraliaDiscipline of Genetic Counselling, Graduate School of Health, University of Technology Sydney, Sydney, NSW, AustraliaDiscipline of Genetic Counselling, Graduate School of Health, University of Technology Sydney, Sydney, NSW, AustraliaParkville Familial Cancer Centre, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, VIC, AustraliaDepartment of Oncology, Royal Women’s Hospital, Parkville, VIC, AustraliaHunter Genetics, Hunter Family Cancer Service, Newcastle, NSW, AustraliaHereditary Cancer Clinic, Prince of Wales Hospital, Sydney, NSW, AustraliaDivision of Clinical Cancer Genomics, Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United StatesGenomic Medicine Institute, Geisinger, Danville, PA, United StatesFaculty of Medicine and Health, University of Sydney, Sydney, NSW, AustraliaCancer Research Division, Cancer Council NSW, Sydney, NSW, AustraliaFaculty of Medicine and Health, University of Sydney, Sydney, NSW, AustraliaFaculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia0Melbourne School of Population and Global Health, Melbourne University, Melbourne, VIC, AustraliaIntroduction“Mainstreaming” is a proposed strategy to integrate genomic testing into oncology. The aim of this paper is to develop a mainstreaming oncogenomics model by identifying health system interventions and implementation strategies for mainstreaming Lynch syndrome genomic testing.MethodsA rigorous theoretical approach inclusive of conducting a systematic review and qualitative and quantitative studies was undertaken using the Consolidated Framework for Implementation Research. Theory-informed implementation data were mapped to the Genomic Medicine Integrative Research framework to generate potential strategies.ResultsThe systematic review identified a lack of theory-guided health system interventions and evaluation for Lynch syndrome and other mainstreaming programs. The qualitative study phase included 22 participants from 12 health organizations. The quantitative Lynch syndrome survey included 198 responses: 26% and 66% from genetic and oncology health professionals, respectively. Studies identified the relative advantage and clinical utility of mainstreaming to improve genetic test access and to streamline care, and adaptation of current processes was recognized for results delivery and follow-up. Barriers identified included funding, infrastructure and resources, and the need for process and role delineation. The interventions to overcome barriers were as follows: embedded mainstream genetic counselors, electronic medical record genetic test ordering, results tracking, and mainstreaming education resources. Implementation evidence was connected through the Genomic Medicine Integrative Research framework resulting in a mainstreaming oncogenomics model.DiscussionThe proposed mainstreaming oncogenomics model acts as a complex intervention. It features an adaptable suite of implementation strategies to inform Lynch syndrome and other hereditary cancer service delivery. Implementation and evaluation of the model are required in future research.https://www.frontiersin.org/articles/10.3389/fonc.2023.1140135/fullLynch syndromeroutine genetic testingoncology service deliverymainstreamingoncogenomics model |
| spellingShingle | Rosie O’Shea Ashley Crook Chris Jacobs Maira Kentwell Maira Kentwell Margaret Gleeson Katherine M. Tucker Heather Hampel Alanna Kulchak Rahm Natalie Taylor Natalie Taylor Sarah Lewis Nicole M. Rankin Nicole M. Rankin A mainstreaming oncogenomics model: improving the identification of Lynch syndrome Frontiers in Oncology Lynch syndrome routine genetic testing oncology service delivery mainstreaming oncogenomics model |
| title | A mainstreaming oncogenomics model: improving the identification of Lynch syndrome |
| title_full | A mainstreaming oncogenomics model: improving the identification of Lynch syndrome |
| title_fullStr | A mainstreaming oncogenomics model: improving the identification of Lynch syndrome |
| title_full_unstemmed | A mainstreaming oncogenomics model: improving the identification of Lynch syndrome |
| title_short | A mainstreaming oncogenomics model: improving the identification of Lynch syndrome |
| title_sort | mainstreaming oncogenomics model improving the identification of lynch syndrome |
| topic | Lynch syndrome routine genetic testing oncology service delivery mainstreaming oncogenomics model |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1140135/full |
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