Promoting Cancer Genomics Best Practices through Surveillance, Education and Policy Change in the State of Michigan, 2008-2011
The MDCH Genomics Program, in collaboration with the CDC Office of Public Health Genomics, is identifying and promoting cancer genomics best practices for appropriate translation of cancer genetic tests and gene profiling tests into clinical and public health practice. Project goals include:
1)
Developing and implementing a model for surveillance of inherited cancers and use of relevant genetic tests
2)
Identifying model provider education programs to increase use of appropriate screening, counseling and evidence-based genetic tests
3)
Identifying a model health insurance policy for BRCA1 & 2 cancer genetic testing
Methods:
The core MDCH team includes a project director, coordinator, cancer genomics educator and epidemiologist. In addition, we have identified the partners needed to 1) develop a surveillance system to monitor the use of genetic counseling and testing for BRCA1/2, and the use of genetic tests for colorectal cancer (Lynch Syndrome); 2) implement educational activities; and 3) identify the need for health plan policy changes in relation to the US Preventive Services Task Force Guidelines for the use of BRCA testing. Multiple different activities will address each of these objectives. For further details, please see our logic model.
This project's target population encompasses the entire state of Michigan and includes patients with or at increased risk for specific cancers, providers, health systems, and health insurance plans. Evaluation is based on methods recommended by the Guide to Community Preventive Services, and is designed to demonstrate an increase from baseline measures.
Expected Outcomes:
After completion of the Cancer Genomics project, we anticipate the following outcomes related to surveillance, education and policy.
Surveillance
a)
Increased understanding of statewide mortality associated with hereditary breast/ovarian, colorectal and other HNPCC-related cancers
b)
A description of provider practices regarding the use of family history assessment, genetic counseling, and genetic testing in patients with cancer
c)
An assessment of barriers and facilitators to cancer survivor knowledge, attitudes and use of family history, genetic counseling and testing
d)
Development of new methods for collecting data on the clinical use of BRCA1 & 2 genetic testing.
Education
a)
Increased use of USPSTF clinical practice guidelines for BRCA1 & 2 testing.
b)
Increased provider awareness about the validity, utility, harms, and benefits of HNPCC mismatch repair testing and gene expression profiling tests for breast cancer.
Policy
a)
An increased understanding of the current status of health insurance policies for BRCA1 & 2 genetic testing with respect to USPSTF guidelines
b)
An increased number (from baseline) of health insurance plans that have policies consistent with USPSTF clinical practice guidelines for BRCA 1 & 2 testing.
Results:
This genomics translation project has just completed its first year of activity, with data collection currently underway. Accomplishments to date include:
Developed survey instruments and databases for collection of hospital medical record and genetics clinic data.
ü
Analyzed historical cancer registry data
ü
Collected baseline information on health plan policies for BRCA 1/2 counseling and testing
ü
Initiated development of educational materials
Additional progress will be shared on this website in the future. For further information, please call 1-866-852-1247 or email Genetics@michigan.gov
Michigan's Cancer Genomics project is supported by Cooperative Agreement #5U38GD000054 from the Centers for Disease Control and Prevention (CDC). The contents of this webpage are the sole responsibility of the authors and do not necessarily represent the official views of CDC.
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