Impact of an immunohistochemistry-based universal screening protocol for XXXX in @entity1204 on genetic counseling and testing.

@entity1204 @entity1 @entity4309 @entity8433 @entity1062
OBJECTIVE: Evaluate effects of a @entity4309 universal screening protocol in newly diagnosed @entity1204 on subsequent genetic counseling (GC) and @entity1062 ( @entity1062 ) referral and acceptance rates. METHODS: We performed a retrospective cohort study of @entity1 who underwent a hysterectomy for @entity1204 at Barnes Jewish Hospital in St. Louis, MO between 1/1/2011 and 12/31/2013 (n=637). An immunohistochemistry-based (IHC) universal screening protocol for @entity4309 was initiated on 12/17/2012. The cohorts consisted of @entity1 presenting prior to (Pre-Em-USP; n=395) and those presenting following (Em-USP; n=242) initiation of the universal screening protocol. GC and @entity1062 referrals were based on risk factors and/or IHC results. Comparisons were made using the Fisher's exact test and the Kruskal-Wallis test. RESULTS: A greater proportion of individuals in the Em-USP cohort underwent @entity1062 than in Pre-Em-USP (9.1% vs 4.8%, p<0.05). Of individuals with an IHC screening result suggestive of @entity8433 , those within the Em-USP cohort were significantly more likely to accept GC compared to those in the Pre-Em-USP cohort (95% vs 64%, p=0.02). Specifically within the Em-USP cohort, @entity1 referred to GC due to a concerning IHC screening result, versus those who were referred based on other risk factors, had a higher counseling acceptance rate (95% vs 61%, p=0.03) and underwent genetic testing more readily (76% vs 30%, p<0.001). CONCLUSIONS: Implementation of an IHC-based universal screening protocol for @entity8433 in @entity1204 leads to higher acceptance of genetic counseling and higher rates of genetic testing compared to referral based on risk factors alone.
