Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Consensus Recommendations For Genetic Testing In Prostate Cancer: A Delphi Study (#61)

Haitham Tuffaha 1 , Kim Edmunds 1 , David Fairbairn 2 , Matthew Roberts 3 , Lisa Horvath 4 , David Smith 5 , Shiksha Arora 1 , Suzanne Chambers 6 , Paul Scuffham 7
  1. Centre for the Business and Economics of Health, The University of Queensland, Brisbane, QLD, Australia
  2. Pathology Queensland, The Royal Brisbane Women’s Hospital, Brisbane, Queensland, Australia
  3. Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
  4. Chris O'Brien Lifehouse , Sydney, NSW, Australia
  5. The Daffodil Centre, Sydney, NSW, Australia
  6. The Faculty of Health Sciences,, Australian Catholic University, Brisbane, Queensland, Australia
  7. Menzies Health Institute Queensland, Gold Coast, Queensland, Australia

Aim

Genetic testing could inform precision treatment and early cancer detection; however, there are no Australian guidelines for genetic testing in prostate cancer (PCa). We aimed to estimate the consensus of Australian consumers and health providers on international genetic testing recommendations for PCa.

Methods

We conducted a Delphi study that involved a scoping review of current international guidelines for genetic testing in PCa. Recommendations from the review were synthesised into an online survey that was administered over two rounds. Two panels were surveyed: a patient/carer (P/C) panel (n=27) and a multidisciplinary healthcare provider/researcher (HP/R) panel (n=36). Consensus was set at 70% threshold. Descriptive statistics was utilised to estimate consensus and a thematic analysis of participants’ comments was conducted.

Results

There was a consensus on testing men with a family history of a high-risk hereditary gene, men with PCa and a family history of Hereditary Breast and Ovarian Cancer syndrome or Lynch syndrome, and men with metastatic PCa. There was a consensus on testing BRCA2, BRCA1 and DNA MMR genes for men with metastatic PCa. P/Cs had consistently higher levels of consensus than HP/Rs across recommendations. There was a consensus across the HP/R and P/C panels that genetic counselling requires specialised training; however, P/Cs preferred face to face counselling while HP/Rs favoured counselling via telehealth. Thematic analysis of HP/R comments revealed three main recurring topics: the lack of information to make a decision, insufficient knowledge of genetic testing, and capacity to provide genetic testing and counselling.

Conclusions

This is the first Australian study on genetic testing recommendations in PCa to inform who should be tested and how. While the need for genetic testing is widely accepted, our study showed apparent deficits in knowledge and implementation, exacerbated by workforce issues around the provision of genetic counselling and testing. Future work should focus on evaluating these recommendations for implementation in Australian practice.