Adult survivors of childhood cancers face an increased risk for developing new cancers later in life, such as breast, colorectal, sarcomas, and thyroid cancer. While treatments from their earlier cancer contribute to this risk, about 13 percent of survivors also have a hereditary predisposition that raises the likelihood of subsequent cancers.
A recent clinical trial published in Lancet Regional Health – Americas evaluated whether remote genetic services could improve access to genetic counseling and testing among this group. The study involved 391 participants with an average age of 44. All were given information about the benefits of genetic testing.
Lead author Tara Henderson, MD, MPH, Chair of Pediatrics at Ann & Robert H. Lurie Children's Hospital of Chicago and Professor at Northwestern University Feinberg School of Medicine, stated: "Identifying survivors with cancer-predisposing genetic variants allows personalized survivorship care with early screenings and preventive measures." She added: "Our study is the first national randomized trial to show that remote telehealth services, working with primary care providers, improve access to genetic counseling and testing for adult survivors of childhood cancers. Genetic services also drive earlier detection of subsequent cancer, which reduces morbidity and mortality."
At six months after enrollment in the study, 43 percent of those assigned to receive remote telehealth-based genetic services completed counseling or testing. This was higher than the 15 percent observed in the usual care group.
Dr. Henderson commented on these findings: "Notably, 10 percent of participants who completed genetic testing in the telehealth group had actionable results, which underscores the significant impact of this intervention for the survivors and their families." She continued: "Better access to genetic services is critical for improving outcomes in childhood cancer survivors. We show that integrating remote genetic services in primary care works well, although more survivors still need to pursue genetic testing. Enhancing motivation for testing may require personalized decision aids, further education about its benefits, and financial support mechanisms to reduce concerns about testing costs."
