Genetic Counseling Program

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Impact of EGAPP Recommendations for Colorectal Cancer Genetic Testing On Genetic Counseling Sessions.  By Emily Walsh

Background:  The Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group (2009) suggests that there is sufficient evidence to warrant genetic testing for Lynch syndrome for all individuals newly diagnosed with colorectal cancer (CRC).  This study assessed the impact of these EGAPP recommendations by examining 1) cancer genetic counselors’ familiarity with current EGAPP recommendations, 2) the proportion of institutions that have altered their policies to conform to EGAPP recommendations, and 3) the impact of changes in protocol on genetic counseling services these recommendations have had.  Methods: Data was collected using an online survey sent to cancer genetic counselors through the National Society of Genetic Counselors main listserve and the Cancer Special Interest Group listserve.  Results:  The overall response rate for the survey was 17%.  Of the sample population, 91% was familiar with EGAPP guidelines regarding colon cancer tumor testing, and approximately 35% of institutions at which participants practice have implemented these guidelines.  The most commonly reported protocol for colon cancer tumor testing was ordering IHC and MSI together, followed by gene testing if indicated.  This was also the most preferred protocol among participants who were dissatisfied with their institution’s protocol.  In comparison to 2008, participants whose institutions follow EGAPP guidelines reported significantly more colon cancer patient referrals per week than those whose institutions do not follow EGAPP guidelines (p=0.015), and these institutions have not added additional genetic counselors to accommodate the increased patient load.  Participants reported that they had sufficient time for genetic counseling sessions, and generally reported positive attitudes towards EGAPP guidelines.

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  • "I chose to attend UNCG because of its shared learning environment and the access to some of the leading institutions in the country. "

  • "UNCG is a great fit for me. The program directors have extensive experience in the world of genetic counseling and provide you with opportunities to work with some of the best medical centers in the country. Our location allows us to have expert guest lecturers, many of whom you also get to work alongside or observe in your clinical rotations in your second year. We also have some really wonderful and unique opportunities as a part of this program: we observe in syndrome specific support groups and clinics, tour genetic laboratories, and are matched with a family with a genetic disease to learn what it is like to live with a genetic condition. Finally, our directors are genuinely invested in each of us, and care about our success and getting to know each of us personally."

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