Is BRCA1/2 Genetic Counseling by Telephone Inferior to a Face-to-face Interaction?

Telephone interviews to deliver genetic counseling may be non-inferior to in-person counseling.
Telephone interviews to deliver genetic counseling may be non-inferior to in-person counseling.

Demand for BRCA1/2 genetic mutation testing to assess risk of hereditary breast and ovarian cancer has created an “urgent need to enhance the accessibility and reach” of cancer genetic services. This need is being met by use of the telephone to deliver genetic counseling, a route that may be non-inferior to in-person counseling, according to concluded study published in the Journal of Clinical Oncology.1

“Telephone counseling is a type of telemedicine. It is actually the most widely available form of telemedicine. The vast majority of Americans have easy access to telephones (approximately 98%) but many people do not own computers or have ready access to the internet, particularly in rural areas,” lead study author Anita Y. Kinney, PhD, RN, associate director of cancer control and population sciences at the University of New Mexico Comprehensive Cancer Center in Albuquerque, told Cancer Therapy Advisor in an email.

Dr Kinney and colleagues conducted a randomized non-inferiority trial of telephone delivery of BRCA1/2 genetic counseling. They identified and recruited survivors of breast and ovarian cancer using the Utah Population Database and the Utah Cancer Registry. “At-risk female relatives were recruited through survivors who tested positive for a BRCA1/2 mutation,” the authors wrote. Researchers then randomly assigned 495 survivors to in-person and 493 patients to telephone counseling.

A cancer genetic counselor used the same standardized protocol for both in-person and telephone counseling, including the same print materials. Women counseled in-person could provide a sample for genetic testing or take a BRCA1/2 buccal test kit home for later testing. Those counseled via telephone were mailed a genetic test buccal kit.

The same genetic counselor who performed the pre-test counseling delivered post-test counseling, and all participants were mailed a letter “summarizing their personalized risk assessment based on family history and/or genetic test result and management recommendations,” they wrote.

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