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Oncologists' and Cancer Patients' Views on Whole-Exome Sequencing and Incidental Findings: Results from The CanSeq Study

Authors :
Nikhil Wagle
Steven Joffe
Judy Garber
Nelly Oliver
Julie Najita
Sam Wood
Neal I. Lindeman
Eliezer M. Van Allen
Elizabeth Bair
Yolanda Martins
Lara Traeger
Lynette M. Sholl
Levi A. Garraway
Joshua J. Gagne
Pasi A. Jänne
Elyse R. Park
Carol Lowenstein
Stacy W. Gray
Source :
Genetics in medicine : official journal of the American College of Medical Genetics
Publication Year :
2016

Abstract

Although targeted sequencing improves outcomes for many cancer patients, it remains uncertain how somatic and germ-line whole-exome sequencing (WES) will integrate into care. We conducted surveys and interviews within a study of WES integration at an academic center to determine oncologists’ attitudes about WES and to identify lung and colorectal cancer patients’ preferences for learning WES findings. One-hundred sixty-seven patients (85% white, 58% female, mean age 60) and 27 oncologists (22% female) participated. Although oncologists had extensive experience ordering somatic tests (median 100/year), they had little experience ordering germ-line tests. Oncologists intended to disclose most WES results to patients but anticipated numerous challenges in using WES. Patients had moderately low levels of genetic knowledge (mean 4 correct out of 7). Most patients chose to learn results that could help select a clinical trial, pharmacogenetic and positive prognostic results, and results suggesting inherited predisposition to cancer and treatable noncancer conditions (all ≥95%). Fewer chose to receive negative prognostic results (84%) and results suggesting predisposition to untreatable noncancer conditions (85%). The majority of patients want most cancer-related and incidental WES results. Patients’ low levels of genetic knowledge and oncologists’ inexperience with large-scale sequencing present challenges to implementing paired WES in practice. Genet Med 18 10, 1011–1019.

Details

Language :
English
ISSN :
15300366 and 10983600
Volume :
18
Issue :
10
Database :
OpenAIRE
Journal :
Genetics in medicine : official journal of the American College of Medical Genetics
Accession number :
edsair.doi.dedup.....038eb3b48bf812e3ced1b9c204e90319