![]() ![]() This enables carriers to engage in effective screening protocols, detect and treat cancer early, and educate relatives. CRC (and other cancer) patients identified as being at high risk of LS can be referred for genetic counselling to Family Cancer Clinics (FCCs) where a definitive genetic test can be undertaken with the patient’s consent. In Australia there were around 17,000 new CRC cases in 2014 and this figure is projected to rise to around 20,000 by 2020. Globally, there were an estimated 1.36 million new cases of CRC in 2012, with 134,349 in the United States and 40,775 in the United Kingdom. Lynch syndrome (LS), an inherited disorder involving many types of cancer, is found in 2–5 % of colorectal cancers (CRCs). Identification and referral of patients with a relevant clinical or family history of cancer can save the lives of those affected by hereditary cancers. Enhancing the process of identifying and referring people at high-likelihood risk of Lynch syndrome for genetic counselling will improve outcomes for patients and their relatives, and potentially save public money. This project is based on a tested and refined implementation strategy (TDFI approach). Run charts will be used to continuously monitor change in referrals over time, based on scheduled monthly audits. A paired t-test will be used to assess the mean time from the pathology test results to referral for high-likelihood Lynch syndrome patients pre-post intervention. Chi square analysis will be used to test the difference in the proportion of high-likelihood risk Lynch syndrome patients being referred for genetic testing before and after intervention implementation. Steps are: 1) form local multidisciplinary teams to map current referral processes 2) identify target behaviours that may lead to increased referrals using discussion supported by a retrospective audit 3) identify barriers to those behaviours using the validated Influences on Patient Safety Behaviours Questionnaire and TDFI guided focus groups 4) co-design interventions to address barriers using focus groups 5) co-implement interventions and 6) evaluate intervention impact. The six-step Theoretical Domains Framework Implementation (TDFI) approach will be used at two large, metropolitan hospitals treating colorectal cancer patients. The aim of this project is to use behaviour change theory and implementation science approaches to increase the number and speed of healthcare professional referrals of colorectal cancer patients with a high-likelihood risk of Lynch syndrome to appropriate genetic counselling services. However, over the past decade, international studies have reported that only a small proportion of individuals with suspected Lynch syndrome were referred for genetic consultation and possible genetic testing. If diagnosed early, carriers of Lynch syndrome can undergo increased surveillance for cancers, which in turn can prevent late stage cancers, optimise treatment and decrease mortality for themselves and their relatives. The definitive diagnostic germline test requires formal patient consent after genetic counselling. Lynch syndrome is diagnosed through a combination of significant family and clinical history and pathology. Lynch syndrome is an inherited disorder associated with a range of cancers, and found in 2–5 % of colorectal cancers.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |