myriad presentation feb 2012 grant project

Kathryn Murray, MS, CGC Center for Genetics

February 2012

541-349-7600

Community Cancer Risk Assessment

Project

We have such a great community of

Providers and Families

ITS versus Referral Models

Referral – Weaknesses

Bottlenecks are created.

Significant PT fallout from referral to visit.

Lack of ownership.

Referral HCP level of cancer syndrome education.

– Strenths Quality of counseling process.

Unaffected family member testing.

Identify rare forms of hereditary cancer syndromes.

Independent Testing Site (ITS) – Weaknesses

Rarer syndromes not identified.

Family members rarely tested.

Quality of counseling process.

– Strengths Ownership.

Convenience for patient.

Less bottleneck.

HCP may have a higher level of understanding for the cancer syndrome being tested for.

HCP: Cancer

Genetic Counseling

HCP: PCP

HCP: OB/GYN HCP: Out of Area

Community Risk Assessment Model

can maximize the strengths and minimize

the weaknesses

of both of the other models

(Referral VS ITS)

How do we do this???

• Meet with the different practices.

• Determine their level of interest.

• Identify the Champion(s) in the Office.

• Determine their educational needs.

Assessment:

Average Risk Moderate Risk High Risk

Colonoscopy

beginning

@ 50 years,

no polyps

every 10 years.

NCCN Version 2.2011

1st degree relative CRC

> 60 yrs.

Colonoscopy

beginning

@ 50 years,

no polyps

every 5 years.

Mutation Carrier.

Colonoscopy

beginning

@ 20-25 years,

repeat every

1- 2 years.

Other extra-colonic

screening

recommended.

How do we do this???

• Provide Education.

• Provide Support.

• Build a Community of Providers that are interested in

seeing these patients and triaging their care.

Integration:

How do we do this???

• What works for each practice – may be different.

• How can we expand the circle?

Evaluation:

HCP: Cancer

Genetic Counseling

HCP: PCP

HCP: OB/GYN HCP: Out of Area

Genetics

Providing

Cancer Risk Assessment.

Providing

better management.

GI Oncologist

Surgeons Pathology

Genetics

Providing

Cancer Risk Assessment.

Providing

better management.

HCP: PCP

GI Oncologist

Surgeons Pathology

OB/GYN Out of Area

Conclusion:

• We can develop an integrated model that will

minimize the weaknesses of both referral and ITS

models while maintaining both of their strengths.

• We can serve more patients by providing a more

individualized medical management plan.

• In the end, I believe we can reduce morbidity and

mortality.

Kathryn Murray, MS, CGC