Two young girls with acute lymphocytic leukaemia (ALL) receiving chemotherapy. They are sitting on a bed and are demonstrating some of the procedures and techniques used with intravenous chemotherapy. The girl on the left has an IV tube in the neck, the other girl’s IV is in her arm, which has an arm board which stabilises the arm for IV needle insertion. Credit: Bill Branson (Photographer), Public domain, via Wikimedia Commons.
For survivors at increased risk for subsequent cancer, testing for hereditary predisposition drives earlier detection.
Adult survivors of childhood cancers are at higher risk for another cancer – such as breast, colorectal, sarcomas and thyroid cancer – that is not a relapse of their original illness.
Previous cancer therapies are largely responsible; however, up to 13% of survivors also have hereditary predisposition that elevates their risk of subsequent cancer.
A recent clinical trial found that genetic services via remote centralised telehealth and in collaboration with primary care increased the uptake of genetic counselling and testing in this population.
Lead author Tara Henderson, MD, MPH, is a childhood cancer survivorship expert and chair of Paediatrics at Ann & Robert H Lurie Children’s Hospital of Chicago, as well as professor of paediatrics at Northwestern University Feinberg School of Medicine, said: “Identifying survivors with cancer-predisposing genetic variants allows personalised survivorship care with early screenings and preventive measures.
“Our study is the first national randomised trial to show that remote telehealth services, working with primary care providers, improve access to genetic counselling and testing for adult survivors of childhood cancers.
“Genetic services also drive earlier detection of subsequent cancer, which reduces morbidity and mortality.”
Benefits of genetic testing
The study included 391 participants, with a mean age of 44 years. All participants were provided with information on the benefits of genetic testing.
Henderson and colleagues found that at six months, 43% of participants in the remote telehealth services group received genetic services, compared to 15% in the usual care group.
She added: “Notably, 10% of participants who completed genetic testing in the telehealth group had actionable results, which underscores the significant impact of this intervention for the survivors and their families.
“Better access to genetic services is critical for improving outcomes in childhood cancer survivors.
“We show that integrating remote genetic services in primary care works well, although more survivors still need to pursue genetic testing.”
Henderson concluded: “Enhancing motivation for testing may require personalised decision aids, further education about its benefits, and financial support mechanisms to reduce concerns about testing costs.”
The results are published in Lancet Regional Health – Americas.
