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Cost-effectiveness evaluation of pre-counseling telephone interviews before face-to-face genetic counseling in cancer genetics

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Abstract

One of the main challenges in cancer genetics is responding to the exponential demand for genetic counseling, especially in patients with breast and/or ovarian cancer. To address this demand, we have set up a new procedure, based on pre-genetic counseling telephone interviews (PTI) followed by routing of patients: D1, a PTI is scheduled within 14 days; D7–D14, genetic counselors perform a 20 min PTI in order to establish a pre-genetic counseling file, by collecting personal and family medical history via a structured questionnaire and; D10–17, routing: pre-genetic counseling appointment files are analyzed by a cancer geneticist with 3 possible conclusions: (a) priority face-to-face genetic counseling (FTFGC) appointment with a cancer geneticist, if the genetic test results have an immediate therapeutic impact; (b) non-priority FTFGC with a genetic counselor, or (c) no FTFGC required or substitution by a more appropriate index case. In the context of breast and/or ovarian cancer, 1012 patients received PTIs, 39.1% of which did not lead to FTFGC. The mean delay for non-priority FTFGC was maintained at 18 weeks and priority FTFGC appointments were guaranteed within 8 weeks. The required resources for 1012 patients was estimated at 0.12 FTE secretaries, 0.62 FTE genetic counselors and 0.08 FTE cancer geneticists and the procedure was shown to be cost-effective. This new procedure allows the suppression of up to 1/3 of appointments, guarantees priority for appointments with therapeutic impact and optimizes the interaction and breakdown of tasks between genetic counselors and cancer geneticists.

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Acknowledgements

The authors are grateful to Nikki Sabourin-Gibbs for critical review of the manuscript and to the French National Cancer Institute (INCa) for support.

Funding

No specific funding has been received for this project.

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Authors and Affiliations

  1. Department of Genetics, Rouen University Hospital, Normandy Centre for Genomic and Personalized Medicine, 76000, Rouen, France

    Gaëlle Collet, Nathalie Parodi, Kevin Cassinari, Zoe Neviere, Afane Brahimi, François Lecoquierre, Jean-Christophe Thery, Isabelle Tennevet & Thierry Frebourg

  2. Department of Genetics, Comprehensive Cancer Centre François Baclesse, Normandy Centre for Genomic and Personalized Medicine, 14000, Caen, France

    Zoe Neviere, Fanny Cohen, Céline Gasnier & Pascaline Berthet

  3. Department of Oncology, Comprehensive Cancer Centre Henri Becquerel, Normandy Centre for Genomic and Personalized Medicine, 76000, Rouen, France

    Jean-Christophe Thery & Isabelle Tennevet

  4. Department of Genetics, Le Havre General Hospital, Normandy Centre for Genomic and Personalized Medicine, 76600, Le Havre, France

    Elodie Lacaze

  5. Department of Genetics, Rouen University Hospital, 22 boulevard Gambetta, 76183, Rouen Cedex 1, France

    Thierry Frebourg

Authors
  1. Gaëlle Collet
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  2. Nathalie Parodi
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  3. Kevin Cassinari
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  4. Zoe Neviere
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  5. Fanny Cohen
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  6. Céline Gasnier
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  7. Afane Brahimi
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  8. François Lecoquierre
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  9. Jean-Christophe Thery
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  10. Isabelle Tennevet
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  11. Elodie Lacaze
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  12. Pascaline Berthet
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  13. Thierry Frebourg
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Correspondence to Thierry Frebourg.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research involving human and animal participants

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Collet, G., Parodi, N., Cassinari, K. et al. Cost-effectiveness evaluation of pre-counseling telephone interviews before face-to-face genetic counseling in cancer genetics. Familial Cancer 17, 451–457 (2018). https://doi.org/10.1007/s10689-017-0049-z

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  • DOI: https://doi.org/10.1007/s10689-017-0049-z

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