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Genetic Counseling Via Telephone Just as Effective as In Person

Marc Schwartz  “It’s important that all people interested in testing have access to thorough information so they can consider the implications of test results and interpret them in the context of family history,” said Marc Schwartz, co-leader of Georgetown Lombardi's Cancer Prevention and Control Program.

January 22, 2014 – Genetic counseling delivered over the phone is just as effective as face-to-face counseling, Georgetown researchers reported yesterday in the Journal of Clinical Oncology.

The multi-center study, led by researchers at Georgetown Lombardi Comprehensive Cancer Center, represents the largest randomized investigation to date comparing the two methods.

These days genetic testing includes a range of diseases and demand for testing and counseling, says lead investigator Marc Schwartz, co-leader of Georgetown Lombardi’s Cancer Prevention and Control Program.

Reduces Costs, Improves Access

“It’s important that all people interested in testing have access to thorough information so they can consider the implications of test results and interpret them in the context of family history,” says Schwartz, also co-leader of Georgetown’s Fisher Center for Familial Cancer Research. “Counseling on the phone reduces costs and expands genetic testing access to rural areas, where counseling isn’t always available.”

While the study was conducted with women considering testing for mutations in the breast or ovarian cancer genes BRCA1 and/or BRCA2, the findings “may extend to genetic counseling for other hereditary cancers and complex conditions in adults such as heart disease,” says co-author Beth N. Peshkin, a professor of oncology and senior genetic counselor at Georgetown Lombardi.

The study randomized 669 women to receive telephone or in-person genetic counseling. The authors note that of the women approached about participating in the study, about one-third declined because they did not want to receive phone counseling.

No Less Effective

The majority of participants had been treated for breast or ovarian cancer, and the rest were at risk for the disease because a family member had a mutation previously identified in the BRCA1 or BRCA2 genes.

Participants received genetic counseling either by phone or in person before and after genetic testing, and were surveyed on a number of variables, including their knowledge of the test, perceived stress, satisfaction and decision conflict.

The findings demonstrate that telephone counseling is as effective as in-person counseling.

“We hypothesized that telephone counseling would be comparable to in-person counseling overall and would be preferable for some participants,” Peshkin says. "It's important for us to learn more about why people prefer one type of counseling over another, and how that affects use and outcomes of genetic counseling."

Researchers at Icahn School of Medicine at Mount Sinai, Vermont Cancer Center, Dana Farber Cancer Institute and the Huntsman Cancer Institute participated in the study.

National Cancer Institute (grants R01 CA108933, U01 CA152958, P30 CA051008), the Georgetown Lombardi Biostatistics and Bioinformatics Shared Resource and the Jess and Mildred Fisher Center for Familial Cancer Research at Georgetown Lombardi supported this study.

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