2023 ACMG Annual Clinical Genetics Meeting Digital Edition: Poster Gallery-Fragmented systems of care: An overview of Canadian health system care models for hereditary cancer syndromes

Fragmented systems of care: An overview of Canadian health system care models for hereditary cancer syndromes

Pdf Summary

In British Columbia (BC), there is a centralized care system for suspected hereditary cancer syndrome patients. Index testing is prioritized for affected individuals, and unaffected individuals who meet family-based criteria can also be tested. Patients in BC currently receive a universal multigene panel that covers most known actionable cancer susceptibility genes. There is also a provincially coordinated screening program for high-risk breast cancer patients.<br /><br />In Ontario, there is a localized care system where healthcare providers refer patients to genetic service sites across the province. Eligibility for testing is based on the patient's personal and family cancer history, and unaffected individuals can also be tested. Patients in Ontario have the option to receive multigene panels, single-gene testing or small gene panels, or targeted testing. Similar to BC, Ontario also has a provincially coordinated screening program for high-risk breast cancer patients.<br /><br />In Newfoundland & Labrador (NL), there is a localized care system with one freestanding dedicated inherited cancer clinic. Unaffected individuals in NL are only eligible for testing if there is a known familial mutation. Providers in NL have the option to choose from a selection of panels, but they rely heavily on outsourced testing, primarily from US-based providers. After positive results, the provincial clinic does not provide ongoing care or navigation. Instead, a network of other specialists are engaged.<br /><br />Overall, there are gaps in healthcare system care for hereditary cancer syndromes across these three Canadian provinces. While BC and Ontario have centralized and localized care systems respectively, NL only has a single freestanding clinic. Unaffected individuals in all three provinces have varying eligibility for testing. Additionally, there are differences in the types of testing offered, with BC having a more comprehensive multigene panel, Ontario offering various testing options, and NL relying on outsourced testing. Further improvements are needed to ensure consistent and comprehensive care for hereditary cancer syndromes in these provinces.

Asset Subtitle

Co-Author - Jordan Sam, MHSc; Presenting Author - Carly Butkowsky, HBSc; Co-Author - Marc Clausen, MA; Co-Author - Chloe Mighton, MSc; Co-Author - Sepideh Rajeziesfahani, MSc; Co-Author - Ridhi Gopalakrishnan, HBSc(IPR); Co-Author - Melyssa Aronson, CGC; Co-Author - Derrick Bishop, NA; Co-Author - Lesa Dawson, MD; Co-Author - Andrea Eisen, MD; Co-Author - Tracy Graham, CGC; Co-Author - Jane Green, PhD, OC ONL, Hon FCCMG, FCAHS; Co-Author - Julee Pauling, NA; Co-Author - Claudia Pavao, NA; Co-Author - Catriona Remocker, PhD(c), RCC; Co-Author - Sevtap Savas, PhD; Co-Author - Sophie Sun, MD; Co-Author - Teresa Tiano, NA; Co-Author - Angelina Tilley, NA; Co-Author - Kevin E. Thorpe, MMath; Co-Author - Kasmintan A. Schrader, MBBS, PhD, FRCPC, DABMGG; Co-Author - Holly Etchegary, PhD; Co-Author - Yvonne Bombard, PhD;

Meta Tag

Cancer Syndromes

Counseling

Genetic Testing

Policy Issues

Psychosocial Issues

Co-Author Jordan Sam, MHSc

Co-Author Marc Clausen, MA

Co-Author Chloe Mighton, MSc

Co-Author Sepideh Rajeziesfahani, MSc

Co-Author Ridhi Gopalakrishnan, HBSc(IPR)

Co-Author Melyssa Aronson, CGC

Co-Author Derrick Bishop, NA

Co-Author Lesa Dawson, MD

Co-Author Andrea Eisen, MD

Co-Author Tracy Graham, CGC

Co-Author Jane Green, PhD, OC ONL, Hon FCCMG, FCAHS

Co-Author Julee Pauling, NA

Co-Author Claudia Pavao, NA

Co-Author Catriona Remocker, PhD(c), RCC

Co-Author Sevtap Savas, PhD

Co-Author Sophie Sun, MD

Co-Author Teresa Tiano, NA

Co-Author Angelina Tilley, NA

Co-Author Kevin E. Thorpe, MMath

Co-Author Kasmintan A. Schrader, MBBS, PhD, FRCPC, DABMGG

Co-Author Holly Etchegary, PhD

Co-Author Yvonne Bombard, PhD

Presenting Author Carly Butkowsky, HBSc

Keywords

British Columbia

centralized care system

multigene panel

provincially coordinated screening program

Ontario

localized care system

genetic service sites

small gene panels

Newfoundland & Labrador

freestanding dedicated inherited cancer clinic