Assessing Comprehensive Care Deficits in US Ovarian Cancer Programs to Inform Quality Improvement Initiatives

2021 Year in Review - Ovarian Cancer

Findings of a national survey of US ovarian cancer programs identified several patient care deficits, including a greater need for the integration of palliative care, social work, dietetics, and financial counseling, and the expansion of clinical trials and genetic testing/counseling.

A national survey of US ovarian cancer programs, conducted by the Association of Community Cancer Centers (ACCC), which assessed comprehensive care deficits to inform quality improvement initiatives, was reported at the 2021 American Society of Clinical Oncology Annual Meeting.

The online 20-question survey administered to ACCC and Society of Gynecologic Oncology members (using the Qualtrics platform and distributed via e-mail) was developed by a steering committee comprising gynecologic oncologists, pathologists, genetic counselors, a nurse navigator, and cancer center administrators. The survey sought to collect data about cancer programs, key needs of patients with ovarian cancer, and barriers to, and opportunities for improving, ovarian cancer care.

A total of 26 responses were received; of these, 26% were from the Comprehensive Community Cancer Programs, 22% were from National Cancer Institute-Designated Comprehensive Cancer Programs, 22% were from Academic Comprehensive Cancer Programs, and 13% were from Integrated Network Cancer Programs. The participants indicated that they treated 22 to 190 (median, 50.5) cases of ovarian cancer per year. The majority of the programs (85%) reported a multidisciplinary team for ovarian cancer and are part of a referral network (61%). All programs had ≥1 trials available for ovarian cancer, with an average of 1.5 phase 2 trials and 2 phase 3 clinical trials available. The programs did not routinely integrate palliative care and comprehensive symptom management, which was generally available by consult (81%), with only 15% available at first appointment and 4% integrated at the time of recurrence.

In terms of genetic testing practices aggregated across programs, 79% of patients received germline multipanel testing, 71% received germline BRCA alone, 50% received somatic multigene, and 51% received somatic BRCA alone. The majority of consultations included genetic counseling (75%), nurse navigation (75%), and social work (50%). Gynecologic oncology programs most frequently ordered genetic evaluations (88%). Genetic testing and counseling was the most frequent choice for a quality improvement project (46%), followed by clinical trial enrollment and availability (23%), multidisciplinary team care (19%), education on best practices (15%), palliative care (15%), and ancillary services (15%).

Based on the findings of a national survey of US ovarian cancer programs, the integration of palliative care, social work, dietetics, financial counseling, and the expansion of clinical trials and genetic testing/counseling were identified as care deficits, whereas multidisciplinary care was typical across a range of cancer programs.

Source: Smeltzer M, Dawkins M, Boehmer L, et al. Assessing comprehensive care deficits in United States (U.S.) ovarian cancer programs to inform quality improvement initiatives. J Clin Oncol. 2021;39(suppl_28):256.

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