TELOMERASE ENDOMETRIAL CELLS ACTIVITY IN HYPERPLASTIC PROCESSES

Objective: To assess the accuracy of gynecologic oncologists’ self-reported rates of genetic counseling (GC) and germline genetic testing (GT) referral for ovarian cancer patients seen at a large comprehensive cancer center.Methods: Gynecologic oncology physicians (n=5) estimated the proportion of ovarian cancer patients referred for GC and GT (range: 0-100%). Objective data on GC/GT referral were abstracted from medical records of ovarian cancer patients newly diagnosed in 2017 (n=81). Paired samples t-tests compared actual rates of GC/GT referral to providers’ estimated rates of GC/GT referral.Results: On average, physicians estimated that in 2017 they recommended GC to 77% (range: 50-100%) and GT to 87% (range: 60-100%) of their ovarian cancer patients (Table 1). Only 49% of patients had a documented GC/GT referral in their medical records. The discrepancy between estimated and actual referral ranged from -2-55% for GC and 0-55% for GT. On average, providers overestimated rates of referral by 22% for GC and 32% for GT (Table 2). The difference between estimated and actual rates of GC referral was not significant (p=0.16); the difference between estimated and actual rates of GT trended towards significance (p=0.06).Conclusions: On average, providers overestimate their GC/GT referral rate for ovarian cancer patients. There is significant variability in provider accuracy. Provider discordance in estimated versus actual GC/GT referral is particularly problematic given the recent approval of Olaparib in frontline, maintenance settings. Better understanding of factors related to physician referral for ovarian cancer patients to genetics is necessary to achieve guideline-concordant. 100% of patients should be referred and this is especially relevant in light of Olaparib approval.