How can Australia integrate routine genetic sequencing in oncology: a qualitative study through an implementation science lens

Abstract

Purpose

This study sought to determine genetics and oncology specialists’ views of integrating BRCA1 and BRCA2 testing in epithelial ovarian and breast cancer into routine practice.

Methods

Qualitative interviews were designed using the Consolidated Framework for Implementation Research. Questions included experiences or views of the BRCA testing processes, implementation needs of oncology health professionals, perceived challenges, and future ideas for interventions to integrate genetic testing into oncology.

Results

Twenty-two participants were interviewed from twelve health organizations and four themes were identified: (1) embracing the shift to mainstream genetic testing, with the majority of participants viewing BRCA testing as clinically useful and routine use important for maintaining a patient centered process; (2) the need for communication networks and role delineation to integrate routine genetic testing; (3) factors that influence sustaining routine genetic testing, including ongoing training, resources and funding, real-world adaptation, system complexity, and champions; and (4) variation in system interventions for integrating routine genetic testing align to organizational context.

Conclusion

Findings illustrate the need for integrating genetic testing into routine oncology, and that adaptation of interventions and processes is essential to sustain a feasible model. An understanding of individual and organizational implementation factors will help to prepare for future integration of routine genetic testing in other cancers.

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Acknowledgements

This research was funded by a Cancer Council New South Wales PhD scholarship and by a Translational Cancer Research Network Clinical PhD Scholarship Top-up award, supported by the Cancer Institute NSW supporting R.O.S. in the completion of her PhD studies in the Faculty of Medicine and Health at the University of Sydney.

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Correspondence to Rosie O’Shea BSc, MSc (GenCouns).

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Disclosure

M.K., M.G., and K.M.T. received remunerations from AstraZeneca in the initial development of BRCA mainstreaming interventions for epithelial ovarian cancer. The other authors declare no conflicts of interest.

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O’Shea, R., Rankin, N.M., Kentwell, M. et al. How can Australia integrate routine genetic sequencing in oncology: a qualitative study through an implementation science lens. Genet Med (2020). https://doi.org/10.1038/s41436-020-0838-x

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Keywords

  • mainstreaming
  • routine genetic testing
  • oncology
  • interventions and implementation