Over-the-Phone Cancer Counseling Found to Reduce Costs

Cost and access burdens among individuals at-risk for cancer improved through phone counseling.

Providing genetic test results over the phone to patients at risk for cancer-causing genetic mutations does not cause individuals additional stress and could be an effective way to help reduce costs and access burdens compared with those who receive results in person, a recent study found.

The study enrolled 900 patients and the findings were presented at the 2016 American Cancer Society of Clinical Oncology (ASCO) Annual Meeting.

“Genetic testing for cancer susceptibility is now an essential component of oncology care, but many patients have to travel to large centers to get genetic testing,” said lead study author Angela R. Bradbury, MD. “While health care providers deliver results for many tests over the phone, results of genetic tests have traditionally been delivered in-person because of the complexity, potential for increased levels of distress, or confusion over what the results could mean. However, our study shows that delivering results over phone was does not generate more distress, even for those with positive results and even now that we are using multi-gene testing.”

The study recruited more than 900 patients who received in-person counseling prior to getting a genetic test for cancer-causing mutations. Participants were randomized to either receive test results in-person or over the phone and asked to report their knowledge on genetic testing, as well as any feelings of depression and anxiety before and after test results were given.

There were 22 genetic counselors used to deliver the test results over the phone across 5 sites. The results of the study showed that participants who received their genetic test results over the phone did not have any more depression, anxiety, or worry about cancer risk than those who received their results in-person.

This was found to be true even in patients who were positive for a cancer causing genetic mutation. Furthermore, those who received their results over the phone had fewer barriers in accessing genetic counseling services compared with patients given their results in-person.

“Delivering results over the phone allows us to provide services to patients at risk for cancer-causing genetic mutations for whom cost and access burdens might otherwise be prohibitive,” Bradbury said. “By providing services over the phone and removing the need to travel to a doctor's office or hospital, we're limiting the disruption to a patient's daily routine, but maintaining the patient-provider relationship and delivering high quality cancer genetic services.”

Although clinical significance still remains unclear, the findings suggest there could be small differences in how well patients understand test results when they receive them over the phone compared with in-person. The authors note that more data is needed to better understand the findings before the widespread implementation of over the phone test results.

“The overall goal of this research is to decrease barriers to genetic testing while ensuring that at-risk patients receive appropriate and accurate information,” said senior study author Susan Domchek, MD. “This study is a step in that direction, and shows that providers can deliver quality services in a way that is convenient for patients.”