Abstract
Purpose
In 2019, the National Comprehensive Cancer Network (NCCN) recommended genetic testing for all patients with pancreatic ductal adenocarcinoma (PDAC). To evaluate the status of implementation of these guidelines in a loco-regional setting, we performed a retrospective, observational study among patients with newly diagnosed PDAC who received oncologic care at Northeast Georgia Medical Center in Georgia.
Methods
Chart abstraction of patients with newly diagnosed PDAC from 1 January 2020 to 31 December 2021 was performed to include information on genetic testing recommendation and completion, and time from diagnosis to testing. The deidentified dataset was then analyzed using appropriate descriptive and associative statistical testing.
Results
Of the cohort of 109 patients, 32 (29.4%) completed genetic screening; 16 (14.7%) were screened within 10 days of diagnosis. Among the 77 (70.6%) patients who did not receive genetic screening, 45 (41.3%) were not recommended genetic screening despite treatment intent with standard of care therapy. However, 32 (29.4%) were not recommended genetic screening in conjunction with a desire to pursue palliative care/hospice/or due to terminal illness.
Conclusions
The study highlighted the gap in implementation of NCCN guideline-directed genetic testing in PDAC patients as only a third underwent testing suggesting the need for systematic processes to facilitate testing. The test was more likely to be completed if done early in the course, especially soon after the diagnosis. Research is needed to explore discussing genetic testing for the large proportion of patients who are terminally ill at diagnosis where genetic screening would potentially benefit the family members.
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Data availability
The data used within this study are from a single institution obtained from patient electronic medical records and de-identification was carried out using the safe harbor method. The data described within this manuscript, identification codes used to identify the study sample, the script for data analysis from the corresponding author are available upon request.
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Acknowledgements
We are in great appreciation of our institution and research department for assisting with data collection for the sole purpose of this study.
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AKG, SB, OA, SR, DS assisted with the conception and study design. AKG, SR assisted with acquisition of data. AKG, SB, OA, SR, AIR, DS assisted with interpretation of data. AKG wrote the main manuscript text. AKG, SR, and AIR helped with preparing Tables 1 & 2. All authors reviewed the manuscript, approved of the final version, and agreed to be accountable for all aspects of the work.
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The study described in this manuscript was performed within the ethical standards of 45 CRF 46. The study was approved of IRB exemption by a local university affiliated Institutional Review Board.
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The study is a retrospective observational study of secondary data from a single institution. There was no direct contact with human subjects for this study.
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Ghosh, A.K., Bhushan, S., Abidoye, O. et al. Evaluating implementation of NCCN guideline-directed genetic screening recommendations for patients with pancreatic ductal adenocarcinoma. Cancer Causes Control 35, 679–684 (2024). https://doi.org/10.1007/s10552-023-01825-5
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DOI: https://doi.org/10.1007/s10552-023-01825-5