Impact of Genetic Counseling on Patient-Reported Electronic Cancer Family History Collection.

Background: Cancer family history is a vital part of cancer genetic counseling (GC) and genetic testing (GT), but increasing indications for germline cancer GT necessitate less labor-intensive models of col-lection. We evaluated the impact of GC on patient pedigrees gener-ated by an electronic cancer family history questionnaire (eCFHQ). Methods: An Institutional Review Board & ndash;approved review of pedi-grees collected through an eCFHQ was conducted. Paired pre-GC and post-GC pedigrees (n=1,113 each group) were analyzed inde-pendently by cancer genetic counselors for changes in patient -reported clinical history and to determine whether the pedigrees met NCCN GT criteria. Discrepancy in meeting NCCN GT criteria between pre-GC and post-GC pedigrees was the outcome variable of logistic regressions, with patient and family history characteristics as covariates. Results: Overall, 780 (70%) patients had cancer (affected), 869 (78%) were female, and the median age was 57 years (interquartile range, 45 & ndash;66 years; range, 21 & ndash;91 years). Of the 1,113 pairs of pre-GC and post-GC pedigrees analyzed, 85 (8%) were blank, 933 (84%) were not discrepant, and 95 (9%) were discrepant in meeting any NCCN GT criteria. Of the discrepant pedigrees, n=79 (83%) became eligible for testing by at least one of the NCCN GT cri-teria after GC. Patients with discrepant pedigrees were more likely to report no or unknown history of GT (odds ratio [OR], 4.54; 95% CI, 1.66 & ndash;18.70; P=.01, and OR, 18.47; 95% CI, 5.04 & ndash;88.73; P,.0001, re-spectively) and belonged to racially and/or ethnically underrepre-sented groups (OR, 1.91; 95% CI, 1.08 & ndash;3.25; P=.02). Conclusions: For most patients (84%), a standalone eCFHQ was sufficient to deter-mine whether NCCN GT criteria were met. More research is needed on the performance of the eCFHQ in diverse patient populations.