Evidence map›Paper›PMID 37644850›Full record

ArticleCancer medicine2023

Risk management actions following genetic testing in the Cancer Health Assessments Reaching Many (CHARM) Study: A prospective cohort study.

Boya Guo, Sarah Knerr, Tia L Kauffman, Kathleen F Mittendorf, Erin Keast, Marian J Gilmore, Heather Spencer Feigelson, Frances L Lynch, Kristin R Muessig, Sonia Okuyama and 10 more

Abstract read
In one paragraph

Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Boya GuoSchool of Public Health, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-8508-4084
Sarah KnerrSchool of Public Health, University of Washington, Seattle, Washington, USA.ORCID 0000-0001-5461-6298
Tia L KauffmanCenter for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.
Kathleen F MittendorfVanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0003-1097-9171
Erin KeastCenter for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.
Marian J GilmoreDepartment of Translational and Applied Genomics, Center for Health Research, Portland, Oregon, USA.
Heather Spencer FeigelsonInstitute for Health Research, Denver, Colorado, USA.ORCID 0000-0001-6691-3740
Frances L LynchCenter for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.ORCID 0000-0002-0547-6812
Kristin R MuessigDepartment of Translational and Applied Genomics, Center for Health Research, Portland, Oregon, USA.ORCID 0000-0001-9883-2224
Sonia OkuyamaDivision of Oncology, Denver Health and Hospital Authority, Denver, Colorado, USA.ORCID 0000-0002-8107-3521
Jamilyn M ZeppDepartment of Translational and Applied Genomics, Center for Health Research, Portland, Oregon, USA.ORCID 0000-0002-7240-2151
David L VeenstraThe Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, Washington, USA.ORCID 0000-0003-0687-0480
Li HsuSchool of Public Health, University of Washington, Seattle, Washington, USA.ORCID 0000-0001-8168-4712
Amanda I PhippsSchool of Public Health, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-1446-2201
Sara LindströmSchool of Public Health, University of Washington, Seattle, Washington, USA.
Michael C LeoCenter for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.ORCID 0000-0001-7052-8183
Katrina A B GoddardDepartment of Translational and Applied Genomics, Center for Health Research, Portland, Oregon, USA.
Benjamin S WilfondTreuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington, USA.
Beth DevineSchool of Public Health, University of Washington, Seattle, Washington, USA.
CHARM Study team

Funding

Exome sequencing in Diverse Populations in Colorado & OregonU01HG007292 · NHGRI · KAISER FOUNDATION RESEARCH INSTITUTE · PI LEO, MICHAEL C, WILFOND, BENJAMIN SIMON · 2017 to 2021
$15.7M
Evolving Our Partnership: The CSER2 Centralized Support Coordinating CenterU24HG007307 · NHGRI · UNIVERSITY OF WASHINGTON · PI FULLERTON, STEPHANIE MALIA, JARVIK, GAIL PAIRITZ · 2017 to 2021
$5.8M
Validation and extension of the PREMM Model for mismatch repair gene mutationsR01CA132829 · NCI · DANA-FARBER CANCER INST · PI SYNGAL, SAPNA · 2008 to 2022
$5.6M
NCI NIH HHS R01 CA132829NHGRI NIH HHS U01 HG007292NHGRI NIH HHS U01HG007292NHGRI NIH HHS U24 HG007307NHGRI NIH HHS U24HG007307
6 · The paper itself

Abstract

backgroundGenetic testing can identify cancer risk early, enabling prevention and early detection. We describe use of risk management interventions following genetic testing in the Cancer Health Assessment Reaching Many (CHARM) study. CHARM assessed risk and provided genetic testing to low income, low literacy, and other underserved populations that historically face barriers to accessing cancer genetic services.

methodsCHARM was implemented in Kaiser Permanente Northwest (KPNW) and Denver Health (DH) between 2018 and 2020. We identified post-testing screening (mammography, breast MRI, colonoscopy) and surgical (mastectomy, oophorectomy) procedures using electronic health records. We examined utilization in participants who did and did not receive actionable risk management recommendations from study genetic counselors following national guidelines.

resultsCHARM participants were followed for an average of 15.4 months (range: 0.4-27.8 months) after results disclosure. Less than 2% (11/680) received actionable risk management recommendations (i.e., could be completed in the initial years following testing) based on their test result. Among those who received actionable recommendations, risk management utilization was moderate (54.5%, 6/11 completed any procedure) and varied by procedure (mammogram: 0/3; MRI: 2/4; colonoscopy: 4/5; mastectomy: 1/5; oophorectomy: 0/3). Cancer screening and surgery procedures were rare in participants without actionable recommendations.

conclusionThough the number of participants who received actionable risk management recommendations was small, our results suggest that implementing CHARM's risk assessment and testing model increased access to evidence-based genetic services and provided opportunities for patients to engage in recommended preventive care, without encouraging risk management overuse.

Indexed as

Breast NeoplasmsFemaleGenetic TestingHumansMastectomyProspective StudiesRisk Assessmentgenetic testinggenomic sequencinghealth service utilizationhereditary breast and ovarian cancerhereditary cancerLynch syndromeunderserved populations

Identifiers

PMID37644850
PMCPMC10557878

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.