Practice patterns and results of tumor and germline genetic evaluation of women with endometrial cancer in south Louisiana
The objectives were to describe rates of MMRd or MSI-H EC tumors, the prevalence of LS, the practice patterns of EC genetic evaluation and adherence to NCCN guidelines, and to identify disparities in the genetic evaluation of women with EC.A retrospective cohort study was performed on women with EC...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-05-01
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| Series: | Gynecologic Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578921000229 |
| _version_ | 1818600546080129024 |
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| author | Morgan McDougal Pallavi Nair-Fairless Tova Weiss Elizabeth Dao Andrew G. Chapple Amelia Jernigan |
| author_facet | Morgan McDougal Pallavi Nair-Fairless Tova Weiss Elizabeth Dao Andrew G. Chapple Amelia Jernigan |
| author_sort | Morgan McDougal |
| collection | DOAJ |
| description | The objectives were to describe rates of MMRd or MSI-H EC tumors, the prevalence of LS, the practice patterns of EC genetic evaluation and adherence to NCCN guidelines, and to identify disparities in the genetic evaluation of women with EC.A retrospective cohort study was performed on women with EC from 1/2013 to 12/2019, and information collected included demographics, personal and family history, EC diagnosis and treatment, and details of genetic evaluation. Statistical analysis included a multivariable logistic regression to adjust for all covariate effects simultaneously and Fisher exact tests of independence and Wilcoxon rank-sum tests to compare categorical and continuous covariates, respectively.Of the 286 women with EC, 80 EC tumors were tested, and 27.5% were MMRd or MSI-H. Of the 21 women who had germline testing, no cases of LS were identified. Before the NCCN recommended universal tumor testing, 17.6% of women had tumor testing performed compared to 60.0% after February of 2017 (OR = 2.51, 95% CI 1.89–3.32). Advanced cancer stage was nearly associated with an increased likelihood of tumor testing (OR = 1.40, 95% CI 1.00–1.97). No disparities were identified.We described patterns of genetic evaluation and tumor testing results for women with EC in south Louisiana and found similar rates of MMRd or MSI-H EC tumors as previously reported in other populations. Rates of tumor testing increased after the NCCN recommendation for universal tumor testing, but it is critical to identify weaknesses in this process and develop an algorithm to improve care for women with EC. |
| first_indexed | 2024-12-16T12:37:12Z |
| format | Article |
| id | doaj.art-812713223934418f8b43d3f9e3533d92 |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-12-16T12:37:12Z |
| publishDate | 2021-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-812713223934418f8b43d3f9e3533d922022-12-21T22:31:32ZengElsevierGynecologic Oncology Reports2352-57892021-05-0136100717Practice patterns and results of tumor and germline genetic evaluation of women with endometrial cancer in south LouisianaMorgan McDougal0Pallavi Nair-Fairless1Tova Weiss2Elizabeth Dao3Andrew G. Chapple4Amelia Jernigan5Louisiana State University Health Sciences Center, School of Medicine, New Orleans, LA, United StatesDepartment of Obstetrics and Gynecology; Louisiana State University Health Sciences Center, New Orleans, LA, United StatesLouisiana State University Health Sciences Center, School of Medicine, New Orleans, LA, United StatesLouisiana State University Health Sciences Center, School of Medicine, New Orleans, LA, United StatesBiostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LADivision of Gynecologic Oncology, Louisiana State University Health Sciences Center, New Orleans, LA, United States; Corresponding author at: 1542 Tulane Avenue, Box T5-2, New Orleans, LA 70112, United States.The objectives were to describe rates of MMRd or MSI-H EC tumors, the prevalence of LS, the practice patterns of EC genetic evaluation and adherence to NCCN guidelines, and to identify disparities in the genetic evaluation of women with EC.A retrospective cohort study was performed on women with EC from 1/2013 to 12/2019, and information collected included demographics, personal and family history, EC diagnosis and treatment, and details of genetic evaluation. Statistical analysis included a multivariable logistic regression to adjust for all covariate effects simultaneously and Fisher exact tests of independence and Wilcoxon rank-sum tests to compare categorical and continuous covariates, respectively.Of the 286 women with EC, 80 EC tumors were tested, and 27.5% were MMRd or MSI-H. Of the 21 women who had germline testing, no cases of LS were identified. Before the NCCN recommended universal tumor testing, 17.6% of women had tumor testing performed compared to 60.0% after February of 2017 (OR = 2.51, 95% CI 1.89–3.32). Advanced cancer stage was nearly associated with an increased likelihood of tumor testing (OR = 1.40, 95% CI 1.00–1.97). No disparities were identified.We described patterns of genetic evaluation and tumor testing results for women with EC in south Louisiana and found similar rates of MMRd or MSI-H EC tumors as previously reported in other populations. Rates of tumor testing increased after the NCCN recommendation for universal tumor testing, but it is critical to identify weaknesses in this process and develop an algorithm to improve care for women with EC.http://www.sciencedirect.com/science/article/pii/S2352578921000229Endometrial NeoplasmsHereditary nonpolyposisDNA mismatch repairMicrosatellite instabilityGenetic testingGenetic counseling |
| spellingShingle | Morgan McDougal Pallavi Nair-Fairless Tova Weiss Elizabeth Dao Andrew G. Chapple Amelia Jernigan Practice patterns and results of tumor and germline genetic evaluation of women with endometrial cancer in south Louisiana Gynecologic Oncology Reports Endometrial Neoplasms Hereditary nonpolyposis DNA mismatch repair Microsatellite instability Genetic testing Genetic counseling |
| title | Practice patterns and results of tumor and germline genetic evaluation of women with endometrial cancer in south Louisiana |
| title_full | Practice patterns and results of tumor and germline genetic evaluation of women with endometrial cancer in south Louisiana |
| title_fullStr | Practice patterns and results of tumor and germline genetic evaluation of women with endometrial cancer in south Louisiana |
| title_full_unstemmed | Practice patterns and results of tumor and germline genetic evaluation of women with endometrial cancer in south Louisiana |
| title_short | Practice patterns and results of tumor and germline genetic evaluation of women with endometrial cancer in south Louisiana |
| title_sort | practice patterns and results of tumor and germline genetic evaluation of women with endometrial cancer in south louisiana |
| topic | Endometrial Neoplasms Hereditary nonpolyposis DNA mismatch repair Microsatellite instability Genetic testing Genetic counseling |
| url | http://www.sciencedirect.com/science/article/pii/S2352578921000229 |
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