Experience of urologists, oncologists and nurse practitioners with mainstream genetic testing in metastatic prostate cancer

Michiel Vlaming; Margreet G.E.M. Ausems; Lambertus A. Kiemeney; Gina Schijven; Harm H.E. van Melick; M. Arjen Noordzij; Diederik M. Somford; Henk G van der Poel; Carl J. Wijburg; Bart Wijsman; Robert J. Hoekstra; RJA van Moorselaar; Bart PJ Bezooijen; Richard P. Meijer; M.B. Busstra; H.P. (Pieter) van den Berg; Debbie Robbrecht; Benjamin HJ Doornweerd; Eveline M.A. Bleiker; Inge M. van Oort

doi:10.1038/s41391-024-00925-w

Experience of urologists, oncologists and nurse practitioners with mainstream genetic testing in metastatic prostate cancer

Michiel Vlaming, Margreet G.E.M. Ausems, Lambertus A. Kiemeney, Gina Schijven, Harm H.E. van Melick, M. Arjen Noordzij, Diederik M. Somford, Henk G van der Poel, Carl J. Wijburg, Bart Wijsman, Robert J. Hoekstra, RJA van Moorselaar, Bart PJ Bezooijen, Richard P. Meijer, M.B. Busstra, H.P. (Pieter) van den Berg, Debbie Robbrecht, Benjamin HJ Doornweerd, Eveline M.A. Bleiker, Inge M. van Oort^*

^*Corresponding author for this work

Medical Oncology

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background:

International guidelines recommend germline genetic testing for men with metastatic prostate cancer. If offered to all patients by genetic healthcare professionals, there will be insufficient capacity to cope with the high patient numbers. In a mainstreaming pathway, non-genetic healthcare professionals (ngHCPs) discuss and order germline genetic testing instead of referring patients to genetic healthcare professionals. We aimed to evaluate the experience of ngHCPs with pre-test genetic counselling and to explore the feasibility from the ngHCPs’ perspective.

Methods:

We carried out a prospective cohort study in 15 hospitals in the Netherlands. All participating ngHCPs (i.e. urologists, medical oncologists, specialist nurses and nurse practitioners) completed an online training module of 45 min. The ngHCPs completed a questionnaire both before the training and at three and nine months after it. Paired analyses were used to compare the first with the last questionnaires on attitude, confidence in the ability to discuss and order germline genetic testing, and perceived and actual knowledge of genetics and genetic testing.

Results:

167 ngHCPs were invited to participate of whom 69 completed the first questionnaire and started or completed the last one. They had a positive attitude towards offering genetic testing themselves. After nine months of providing pre-test genetic counselling, significantly more ngHCPs considered mainstreaming helpful (94% after versus 81% before, p = 0.01). Both perceived and actual knowledge increased significantly. Pre-test genetic counselling took less than 10 minutes for 82% of ngHCPs and the majority (88%) were in favour of continuing the mainstream pathway. Only six participating ngHCPs considered mainstreaming possible without completing a training module beforehand.

Conclusions:

After completing a short online training module, ngHCPs feel well-prepared to discuss germline genetic testing with metastatic prostate cancer patients.

Original language	English
Article number	1365
Journal	Prostate Cancer and Prostatic Diseases
DOIs	https://doi.org/10.1038/s41391-024-00925-w
Publication status	Published - 5 Dec 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

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Cite this

Vlaming, M., Ausems, M. G. E. M., Kiemeney, L. A., Schijven, G., van Melick, H. H. E., Noordzij, M. A., Somford, D. M., van der Poel, H. G., Wijburg, C. J., Wijsman, B., Hoekstra, R. J., van Moorselaar, RJA., Bezooijen, B. PJ., Meijer, R. P., Busstra, M. B., van den Berg, H. P., Robbrecht, D., Doornweerd, B. HJ., Bleiker, E. M. A., & van Oort, I. M. (2024). Experience of urologists, oncologists and nurse practitioners with mainstream genetic testing in metastatic prostate cancer. Prostate Cancer and Prostatic Diseases, Article 1365. https://doi.org/10.1038/s41391-024-00925-w

@article{2969c988118247219f6d334c4809f270,

title = "Experience of urologists, oncologists and nurse practitioners with mainstream genetic testing in metastatic prostate cancer",

abstract = "Background: International guidelines recommend germline genetic testing for men with metastatic prostate cancer. If offered to all patients by genetic healthcare professionals, there will be insufficient capacity to cope with the high patient numbers. In a mainstreaming pathway, non-genetic healthcare professionals (ngHCPs) discuss and order germline genetic testing instead of referring patients to genetic healthcare professionals. We aimed to evaluate the experience of ngHCPs with pre-test genetic counselling and to explore the feasibility from the ngHCPs{\textquoteright} perspective. Methods: We carried out a prospective cohort study in 15 hospitals in the Netherlands. All participating ngHCPs (i.e. urologists, medical oncologists, specialist nurses and nurse practitioners) completed an online training module of 45 min. The ngHCPs completed a questionnaire both before the training and at three and nine months after it. Paired analyses were used to compare the first with the last questionnaires on attitude, confidence in the ability to discuss and order germline genetic testing, and perceived and actual knowledge of genetics and genetic testing. Results: 167 ngHCPs were invited to participate of whom 69 completed the first questionnaire and started or completed the last one. They had a positive attitude towards offering genetic testing themselves. After nine months of providing pre-test genetic counselling, significantly more ngHCPs considered mainstreaming helpful (94% after versus 81% before, p = 0.01). Both perceived and actual knowledge increased significantly. Pre-test genetic counselling took less than 10 minutes for 82% of ngHCPs and the majority (88%) were in favour of continuing the mainstream pathway. Only six participating ngHCPs considered mainstreaming possible without completing a training module beforehand. Conclusions: After completing a short online training module, ngHCPs feel well-prepared to discuss germline genetic testing with metastatic prostate cancer patients.",

author = "Michiel Vlaming and Ausems, {Margreet G.E.M.} and Kiemeney, {Lambertus A.} and Gina Schijven and {van Melick}, {Harm H.E.} and Noordzij, {M. Arjen} and Somford, {Diederik M.} and {van der Poel}, {Henk G} and Wijburg, {Carl J.} and Bart Wijsman and Hoekstra, {Robert J.} and {van Moorselaar}, RJA and Bezooijen, {Bart PJ} and Meijer, {Richard P.} and M.B. Busstra and {van den Berg}, {H.P. (Pieter)} and Debbie Robbrecht and Doornweerd, {Benjamin HJ} and Bleiker, {Eveline M.A.} and {van Oort}, {Inge M.}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = dec,

day = "5",

doi = "10.1038/s41391-024-00925-w",

language = "English",

journal = "Prostate Cancer and Prostatic Diseases",

issn = "1365-7852",

publisher = "Springer Nature",

}

Vlaming, M, Ausems, MGEM, Kiemeney, LA, Schijven, G, van Melick, HHE, Noordzij, MA, Somford, DM, van der Poel, HG, Wijburg, CJ, Wijsman, B, Hoekstra, RJ, van Moorselaar, RJA, Bezooijen, BPJ, Meijer, RP, Busstra, MB, van den Berg, HP, Robbrecht, D, Doornweerd, BHJ, Bleiker, EMA & van Oort, IM 2024, 'Experience of urologists, oncologists and nurse practitioners with mainstream genetic testing in metastatic prostate cancer', Prostate Cancer and Prostatic Diseases. https://doi.org/10.1038/s41391-024-00925-w

TY - JOUR

T1 - Experience of urologists, oncologists and nurse practitioners with mainstream genetic testing in metastatic prostate cancer

AU - Vlaming, Michiel

AU - Ausems, Margreet G.E.M.

AU - Kiemeney, Lambertus A.

AU - Schijven, Gina

AU - van Melick, Harm H.E.

AU - Noordzij, M. Arjen

AU - Somford, Diederik M.

AU - van der Poel, Henk G

AU - Wijburg, Carl J.

AU - Wijsman, Bart

AU - Hoekstra, Robert J.

AU - van Moorselaar, RJA

AU - Bezooijen, Bart PJ

AU - Meijer, Richard P.

AU - Busstra, M.B.

AU - van den Berg, H.P. (Pieter)

AU - Robbrecht, Debbie

AU - Doornweerd, Benjamin HJ

AU - Bleiker, Eveline M.A.

AU - van Oort, Inge M.

PY - 2024/12/5

Y1 - 2024/12/5

N2 - Background: International guidelines recommend germline genetic testing for men with metastatic prostate cancer. If offered to all patients by genetic healthcare professionals, there will be insufficient capacity to cope with the high patient numbers. In a mainstreaming pathway, non-genetic healthcare professionals (ngHCPs) discuss and order germline genetic testing instead of referring patients to genetic healthcare professionals. We aimed to evaluate the experience of ngHCPs with pre-test genetic counselling and to explore the feasibility from the ngHCPs’ perspective. Methods: We carried out a prospective cohort study in 15 hospitals in the Netherlands. All participating ngHCPs (i.e. urologists, medical oncologists, specialist nurses and nurse practitioners) completed an online training module of 45 min. The ngHCPs completed a questionnaire both before the training and at three and nine months after it. Paired analyses were used to compare the first with the last questionnaires on attitude, confidence in the ability to discuss and order germline genetic testing, and perceived and actual knowledge of genetics and genetic testing. Results: 167 ngHCPs were invited to participate of whom 69 completed the first questionnaire and started or completed the last one. They had a positive attitude towards offering genetic testing themselves. After nine months of providing pre-test genetic counselling, significantly more ngHCPs considered mainstreaming helpful (94% after versus 81% before, p = 0.01). Both perceived and actual knowledge increased significantly. Pre-test genetic counselling took less than 10 minutes for 82% of ngHCPs and the majority (88%) were in favour of continuing the mainstream pathway. Only six participating ngHCPs considered mainstreaming possible without completing a training module beforehand. Conclusions: After completing a short online training module, ngHCPs feel well-prepared to discuss germline genetic testing with metastatic prostate cancer patients.

AB - Background: International guidelines recommend germline genetic testing for men with metastatic prostate cancer. If offered to all patients by genetic healthcare professionals, there will be insufficient capacity to cope with the high patient numbers. In a mainstreaming pathway, non-genetic healthcare professionals (ngHCPs) discuss and order germline genetic testing instead of referring patients to genetic healthcare professionals. We aimed to evaluate the experience of ngHCPs with pre-test genetic counselling and to explore the feasibility from the ngHCPs’ perspective. Methods: We carried out a prospective cohort study in 15 hospitals in the Netherlands. All participating ngHCPs (i.e. urologists, medical oncologists, specialist nurses and nurse practitioners) completed an online training module of 45 min. The ngHCPs completed a questionnaire both before the training and at three and nine months after it. Paired analyses were used to compare the first with the last questionnaires on attitude, confidence in the ability to discuss and order germline genetic testing, and perceived and actual knowledge of genetics and genetic testing. Results: 167 ngHCPs were invited to participate of whom 69 completed the first questionnaire and started or completed the last one. They had a positive attitude towards offering genetic testing themselves. After nine months of providing pre-test genetic counselling, significantly more ngHCPs considered mainstreaming helpful (94% after versus 81% before, p = 0.01). Both perceived and actual knowledge increased significantly. Pre-test genetic counselling took less than 10 minutes for 82% of ngHCPs and the majority (88%) were in favour of continuing the mainstream pathway. Only six participating ngHCPs considered mainstreaming possible without completing a training module beforehand. Conclusions: After completing a short online training module, ngHCPs feel well-prepared to discuss germline genetic testing with metastatic prostate cancer patients.

UR - http://www.scopus.com/inward/record.url?scp=85211315131&partnerID=8YFLogxK

U2 - 10.1038/s41391-024-00925-w

DO - 10.1038/s41391-024-00925-w

M3 - Article

C2 - 39639158

SN - 1365-7852

JO - Prostate Cancer and Prostatic Diseases

JF - Prostate Cancer and Prostatic Diseases

M1 - 1365

ER -

Experience of urologists, oncologists and nurse practitioners with mainstream genetic testing in metastatic prostate cancer

Abstract

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