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Title: Predictors of next-generation sequencing panel selection using a shared decision-making approach
Authors: Courtney, E
Li, S.-T
Shaw, T
Chen, Y
Allen, J.C 
Ngeow, J 
Keywords: ATM protein
BRCA1 protein
BRCA2 protein
phosphatidylinositol 3,4,5 trisphosphate 3 phosphatase
protein p53
breast cancer
cancer patient
colorectal cancer
endometrium cancer
familial adenomatous polyposis
family history
genetic association
genetic counseling
genetic screening
major clinical study
malignant neoplasm
middle aged
next generation sequencing
outcome assessment
ovary cancer
patient preference
practice guideline
priority journal
shared decision making
Issue Date: 2018
Citation: Courtney, E, Li, S.-T, Shaw, T, Chen, Y, Allen, J.C, Ngeow, J (2018). Predictors of next-generation sequencing panel selection using a shared decision-making approach. npj Genomic Medicine 3 (1) : 11. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: The introduction of next-generation sequencing panels has transformed the approach for genetic testing in cancer patients, however, established guidelines for their use are lacking. A shared decision-making approach has been adopted by our service, where patients play an active role in panel selection and we sought to identify factors associated with panel selection and report testing outcomes. Demographic and clinical data were gathered for female breast and/or ovarian cancer patients aged 21 and over who underwent panel testing. Panel type was classified as 'breast cancer panel' (BCP) or 'multi-cancer panel' (MCP). Stepwise multiple logistic regression analysis was used to identify clinical factors most predictive of panel selection. Of the 265 included subjects, the vast majority selected a broader MCP (81.5%). Subjects who chose MCPs were significantly more likely to be ?50 years of age (49 vs. 31%; p < 0.05), Chinese (76 vs. 47%; p < 0.001) and have a personal history of ovarian cancer (41 vs. 8%; p < 0.001) with the latter two identified as the best predictors of panel selection. Family history of cancer was not significantly associated with panel selection. There were no statistically significant differences in result outcomes between the two groups. In summary, our findings demonstrate that the majority of patients have a preference for interrogating a larger number of genes beyond those with established testing guidelines, despite the additional likelihood of uncertainty. Individual factors, including cancer history and ethnicity, are the best predictors of panel selection. © 2018 The Author(s).
Source Title: npj Genomic Medicine
ISSN: 20567944
DOI: 10.1038/s41525-018-0050-y
Rights: Attribution 4.0 International
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