Prenatal cfDNA screening results indicative of maternal neoplasm: survey of current practice and management needs
Objective To determine genetic counselors' current practices and management needs for patients with prenatal cfDNA screening results indicative of maternal neoplasm. Methods A survey was completed by genetic counselors recruited via the National Society of Genetic Counselors (NSGC). Results Ove...
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| Veröffentlicht in: | Prenatal diagnosis 2017-02, Vol.37 (2), p.126-132 |
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| creator | Giles, Meagan E. Murphy, Lauren Krstić, Nevena Sullivan, Cathy Hashmi, Syed S. Stevens, Blair |
| description | Objective
To determine genetic counselors' current practices and management needs for patients with prenatal cfDNA screening results indicative of maternal neoplasm.
Methods
A survey was completed by genetic counselors recruited via the National Society of Genetic Counselors (NSGC).
Results
Over 300 genetic counselors were surveyed. Almost all participants (95%) were aware that Noninvasive Prenatal Testing (NIPT) results may suggest maternal neoplasm, and 77% reported they would disclose such results. However, only 29% routinely communicate this possibility to patients in a pre‐test setting. Management recommendations made by counselors were highly variable, and over half (51.8%) stated they would feel uncomfortable or very uncomfortable counseling a patient with these results. While less than half (44.3%) believed the current benefits of NIPT's ability to suggest maternal neoplasm outweigh its potential harms, 80.2% recognized it would be beneficial in the future. A vast majority of counselors (91.3%) felt institutional or national guidelines were needed for patient management.
Conclusion
A majority of counselors neither felt properly equipped nor comfortable counseling patients with prenatal cfDNA results suggestive of maternal neoplasm. This study demonstrates a need for collaboration amongst clinicians, researchers, and laboratories to publish data regarding NIPT results indicative of maternal neoplasm, and for the creation of management guidelines. © 2016 John Wiley & Sons, Ltd.
WHAT'S ALREADY KNOWN ABOUT THIS TOPIC?
Cell‐free DNA is produced by both placental and tumor cells.
Prenatal cell‐free DNA screening has incidentally been found to detect maternal neoplasm.
WHAT DOES THIS STUDY ADD?
This study demonstrates that a consensus is needed regarding the reporting of prenatal cfDNA results indicative of maternal neoplasm.
Guidance is needed for the management of patients with prenatal cfDNA results indicative of maternal neoplasm. |
| doi_str_mv | 10.1002/pd.4973 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1843921840</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1955310234</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3413-82c7255a61face668db317d6b892a20b0bff447b324f10ba4bcd35ce203310793</originalsourceid><addsrcrecordid>eNp90UtLxDAQAOAgiq4P_AcS8CJI17zapN4W1xcs6kHPJU2mUmnTmrTK_ntTVj148JIJmS_DJIPQMSVzSgi76O1c5JJvoRkluUwIY3wbzQiNe65Suof2Q3iLULFc7qI9JpVUirMZen_y4PSgG2yq5cMCB-MBXO1esYcwNkPAtbO10UP9AbircKsH8C5yB13f6NBe4jD6D1hPSTP6WG3AvddmqA1g7Wy84fQrtNO5A7DhEO1Uuglw9B0P0MvN9fPVXbJ6vL2_WqwSwwXliWJGsjTVGa20gSxTtuRU2qxUOdOMlKSsKiFkyZmoKCm1KI3lqQFGOKdE5vwAnW3q9r57HyEMRVsHA02jY-tjKKgSPGdxJZGe_qFv3Ti9Mqo8TWM9xsW_SmVKqFxIGdXJtxrLFmzR-7rVfl38fHkE5xvwWTew_s1TUkyTLHpbTJMsnpZT4F9Xfo6F</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1868489477</pqid></control><display><type>article</type><title>Prenatal cfDNA screening results indicative of maternal neoplasm: survey of current practice and management needs</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Giles, Meagan E. ; Murphy, Lauren ; Krstić, Nevena ; Sullivan, Cathy ; Hashmi, Syed S. ; Stevens, Blair</creator><creatorcontrib>Giles, Meagan E. ; Murphy, Lauren ; Krstić, Nevena ; Sullivan, Cathy ; Hashmi, Syed S. ; Stevens, Blair</creatorcontrib><description>Objective
To determine genetic counselors' current practices and management needs for patients with prenatal cfDNA screening results indicative of maternal neoplasm.
Methods
A survey was completed by genetic counselors recruited via the National Society of Genetic Counselors (NSGC).
Results
Over 300 genetic counselors were surveyed. Almost all participants (95%) were aware that Noninvasive Prenatal Testing (NIPT) results may suggest maternal neoplasm, and 77% reported they would disclose such results. However, only 29% routinely communicate this possibility to patients in a pre‐test setting. Management recommendations made by counselors were highly variable, and over half (51.8%) stated they would feel uncomfortable or very uncomfortable counseling a patient with these results. While less than half (44.3%) believed the current benefits of NIPT's ability to suggest maternal neoplasm outweigh its potential harms, 80.2% recognized it would be beneficial in the future. A vast majority of counselors (91.3%) felt institutional or national guidelines were needed for patient management.
Conclusion
A majority of counselors neither felt properly equipped nor comfortable counseling patients with prenatal cfDNA results suggestive of maternal neoplasm. This study demonstrates a need for collaboration amongst clinicians, researchers, and laboratories to publish data regarding NIPT results indicative of maternal neoplasm, and for the creation of management guidelines. © 2016 John Wiley & Sons, Ltd.
WHAT'S ALREADY KNOWN ABOUT THIS TOPIC?
Cell‐free DNA is produced by both placental and tumor cells.
Prenatal cell‐free DNA screening has incidentally been found to detect maternal neoplasm.
WHAT DOES THIS STUDY ADD?
This study demonstrates that a consensus is needed regarding the reporting of prenatal cfDNA results indicative of maternal neoplasm.
Guidance is needed for the management of patients with prenatal cfDNA results indicative of maternal neoplasm.</description><identifier>ISSN: 0197-3851</identifier><identifier>EISSN: 1097-0223</identifier><identifier>DOI: 10.1002/pd.4973</identifier><identifier>PMID: 27878832</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject><![CDATA[Attitude of Health Personnel ; Deoxyribonucleic acid ; DNA ; DNA - analysis ; DNA - blood ; DNA, Neoplasm - blood ; DNA, Neoplasm - isolation & purification ; Female ; Genetic counseling ; Genetic Counseling - methods ; Genetic Counseling - organization & administration ; Genetic Counseling - statistics & numerical data ; Genetic screening ; Genetic testing ; Guidelines ; Health Services Needs and Demand - organization & administration ; Health Services Needs and Demand - standards ; Health Services Needs and Demand - statistics & numerical data ; Humans ; Management ; Medical screening ; Patients ; Placenta ; Practice Patterns, Physicians' - standards ; Practice Patterns, Physicians' - statistics & numerical data ; Pregnancy ; Pregnancy Complications, Neoplastic - blood ; Pregnancy Complications, Neoplastic - diagnosis ; Pregnancy Complications, Neoplastic - genetics ; Prenatal Diagnosis - methods ; Prenatal Diagnosis - statistics & numerical data ; Referral and Consultation - statistics & numerical data ; Surveys and Questionnaires ; Truth Disclosure ; Tumor cells ; Tumors]]></subject><ispartof>Prenatal diagnosis, 2017-02, Vol.37 (2), p.126-132</ispartof><rights>2016 John Wiley & Sons, Ltd.</rights><rights>2017 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3413-82c7255a61face668db317d6b892a20b0bff447b324f10ba4bcd35ce203310793</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpd.4973$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpd.4973$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27878832$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giles, Meagan E.</creatorcontrib><creatorcontrib>Murphy, Lauren</creatorcontrib><creatorcontrib>Krstić, Nevena</creatorcontrib><creatorcontrib>Sullivan, Cathy</creatorcontrib><creatorcontrib>Hashmi, Syed S.</creatorcontrib><creatorcontrib>Stevens, Blair</creatorcontrib><title>Prenatal cfDNA screening results indicative of maternal neoplasm: survey of current practice and management needs</title><title>Prenatal diagnosis</title><addtitle>Prenat Diagn</addtitle><description>Objective
To determine genetic counselors' current practices and management needs for patients with prenatal cfDNA screening results indicative of maternal neoplasm.
Methods
A survey was completed by genetic counselors recruited via the National Society of Genetic Counselors (NSGC).
Results
Over 300 genetic counselors were surveyed. Almost all participants (95%) were aware that Noninvasive Prenatal Testing (NIPT) results may suggest maternal neoplasm, and 77% reported they would disclose such results. However, only 29% routinely communicate this possibility to patients in a pre‐test setting. Management recommendations made by counselors were highly variable, and over half (51.8%) stated they would feel uncomfortable or very uncomfortable counseling a patient with these results. While less than half (44.3%) believed the current benefits of NIPT's ability to suggest maternal neoplasm outweigh its potential harms, 80.2% recognized it would be beneficial in the future. A vast majority of counselors (91.3%) felt institutional or national guidelines were needed for patient management.
Conclusion
A majority of counselors neither felt properly equipped nor comfortable counseling patients with prenatal cfDNA results suggestive of maternal neoplasm. This study demonstrates a need for collaboration amongst clinicians, researchers, and laboratories to publish data regarding NIPT results indicative of maternal neoplasm, and for the creation of management guidelines. © 2016 John Wiley & Sons, Ltd.
WHAT'S ALREADY KNOWN ABOUT THIS TOPIC?
Cell‐free DNA is produced by both placental and tumor cells.
Prenatal cell‐free DNA screening has incidentally been found to detect maternal neoplasm.
WHAT DOES THIS STUDY ADD?
This study demonstrates that a consensus is needed regarding the reporting of prenatal cfDNA results indicative of maternal neoplasm.
Guidance is needed for the management of patients with prenatal cfDNA results indicative of maternal neoplasm.</description><subject>Attitude of Health Personnel</subject><subject>Deoxyribonucleic acid</subject><subject>DNA</subject><subject>DNA - analysis</subject><subject>DNA - blood</subject><subject>DNA, Neoplasm - blood</subject><subject>DNA, Neoplasm - isolation & purification</subject><subject>Female</subject><subject>Genetic counseling</subject><subject>Genetic Counseling - methods</subject><subject>Genetic Counseling - organization & administration</subject><subject>Genetic Counseling - statistics & numerical data</subject><subject>Genetic screening</subject><subject>Genetic testing</subject><subject>Guidelines</subject><subject>Health Services Needs and Demand - organization & administration</subject><subject>Health Services Needs and Demand - standards</subject><subject>Health Services Needs and Demand - statistics & numerical data</subject><subject>Humans</subject><subject>Management</subject><subject>Medical screening</subject><subject>Patients</subject><subject>Placenta</subject><subject>Practice Patterns, Physicians' - standards</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Neoplastic - blood</subject><subject>Pregnancy Complications, Neoplastic - diagnosis</subject><subject>Pregnancy Complications, Neoplastic - genetics</subject><subject>Prenatal Diagnosis - methods</subject><subject>Prenatal Diagnosis - statistics & numerical data</subject><subject>Referral and Consultation - statistics & numerical data</subject><subject>Surveys and Questionnaires</subject><subject>Truth Disclosure</subject><subject>Tumor cells</subject><subject>Tumors</subject><issn>0197-3851</issn><issn>1097-0223</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90UtLxDAQAOAgiq4P_AcS8CJI17zapN4W1xcs6kHPJU2mUmnTmrTK_ntTVj148JIJmS_DJIPQMSVzSgi76O1c5JJvoRkluUwIY3wbzQiNe65Suof2Q3iLULFc7qI9JpVUirMZen_y4PSgG2yq5cMCB-MBXO1esYcwNkPAtbO10UP9AbircKsH8C5yB13f6NBe4jD6D1hPSTP6WG3AvddmqA1g7Wy84fQrtNO5A7DhEO1Uuglw9B0P0MvN9fPVXbJ6vL2_WqwSwwXliWJGsjTVGa20gSxTtuRU2qxUOdOMlKSsKiFkyZmoKCm1KI3lqQFGOKdE5vwAnW3q9r57HyEMRVsHA02jY-tjKKgSPGdxJZGe_qFv3Ti9Mqo8TWM9xsW_SmVKqFxIGdXJtxrLFmzR-7rVfl38fHkE5xvwWTew_s1TUkyTLHpbTJMsnpZT4F9Xfo6F</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Giles, Meagan E.</creator><creator>Murphy, Lauren</creator><creator>Krstić, Nevena</creator><creator>Sullivan, Cathy</creator><creator>Hashmi, Syed S.</creator><creator>Stevens, Blair</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QP</scope><scope>7T5</scope><scope>7T7</scope><scope>7TK</scope><scope>7TM</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>201702</creationdate><title>Prenatal cfDNA screening results indicative of maternal neoplasm: survey of current practice and management needs</title><author>Giles, Meagan E. ; Murphy, Lauren ; Krstić, Nevena ; Sullivan, Cathy ; Hashmi, Syed S. ; Stevens, Blair</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3413-82c7255a61face668db317d6b892a20b0bff447b324f10ba4bcd35ce203310793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Attitude of Health Personnel</topic><topic>Deoxyribonucleic acid</topic><topic>DNA</topic><topic>DNA - analysis</topic><topic>DNA - blood</topic><topic>DNA, Neoplasm - blood</topic><topic>DNA, Neoplasm - isolation & purification</topic><topic>Female</topic><topic>Genetic counseling</topic><topic>Genetic Counseling - methods</topic><topic>Genetic Counseling - organization & administration</topic><topic>Genetic Counseling - statistics & numerical data</topic><topic>Genetic screening</topic><topic>Genetic testing</topic><topic>Guidelines</topic><topic>Health Services Needs and Demand - organization & administration</topic><topic>Health Services Needs and Demand - standards</topic><topic>Health Services Needs and Demand - statistics & numerical data</topic><topic>Humans</topic><topic>Management</topic><topic>Medical screening</topic><topic>Patients</topic><topic>Placenta</topic><topic>Practice Patterns, Physicians' - standards</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Neoplastic - blood</topic><topic>Pregnancy Complications, Neoplastic - diagnosis</topic><topic>Pregnancy Complications, Neoplastic - genetics</topic><topic>Prenatal Diagnosis - methods</topic><topic>Prenatal Diagnosis - statistics & numerical data</topic><topic>Referral and Consultation - statistics & numerical data</topic><topic>Surveys and Questionnaires</topic><topic>Truth Disclosure</topic><topic>Tumor cells</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giles, Meagan E.</creatorcontrib><creatorcontrib>Murphy, Lauren</creatorcontrib><creatorcontrib>Krstić, Nevena</creatorcontrib><creatorcontrib>Sullivan, Cathy</creatorcontrib><creatorcontrib>Hashmi, Syed S.</creatorcontrib><creatorcontrib>Stevens, Blair</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Prenatal diagnosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giles, Meagan E.</au><au>Murphy, Lauren</au><au>Krstić, Nevena</au><au>Sullivan, Cathy</au><au>Hashmi, Syed S.</au><au>Stevens, Blair</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prenatal cfDNA screening results indicative of maternal neoplasm: survey of current practice and management needs</atitle><jtitle>Prenatal diagnosis</jtitle><addtitle>Prenat Diagn</addtitle><date>2017-02</date><risdate>2017</risdate><volume>37</volume><issue>2</issue><spage>126</spage><epage>132</epage><pages>126-132</pages><issn>0197-3851</issn><eissn>1097-0223</eissn><abstract>Objective
To determine genetic counselors' current practices and management needs for patients with prenatal cfDNA screening results indicative of maternal neoplasm.
Methods
A survey was completed by genetic counselors recruited via the National Society of Genetic Counselors (NSGC).
Results
Over 300 genetic counselors were surveyed. Almost all participants (95%) were aware that Noninvasive Prenatal Testing (NIPT) results may suggest maternal neoplasm, and 77% reported they would disclose such results. However, only 29% routinely communicate this possibility to patients in a pre‐test setting. Management recommendations made by counselors were highly variable, and over half (51.8%) stated they would feel uncomfortable or very uncomfortable counseling a patient with these results. While less than half (44.3%) believed the current benefits of NIPT's ability to suggest maternal neoplasm outweigh its potential harms, 80.2% recognized it would be beneficial in the future. A vast majority of counselors (91.3%) felt institutional or national guidelines were needed for patient management.
Conclusion
A majority of counselors neither felt properly equipped nor comfortable counseling patients with prenatal cfDNA results suggestive of maternal neoplasm. This study demonstrates a need for collaboration amongst clinicians, researchers, and laboratories to publish data regarding NIPT results indicative of maternal neoplasm, and for the creation of management guidelines. © 2016 John Wiley & Sons, Ltd.
WHAT'S ALREADY KNOWN ABOUT THIS TOPIC?
Cell‐free DNA is produced by both placental and tumor cells.
Prenatal cell‐free DNA screening has incidentally been found to detect maternal neoplasm.
WHAT DOES THIS STUDY ADD?
This study demonstrates that a consensus is needed regarding the reporting of prenatal cfDNA results indicative of maternal neoplasm.
Guidance is needed for the management of patients with prenatal cfDNA results indicative of maternal neoplasm.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27878832</pmid><doi>10.1002/pd.4973</doi><tpages>7</tpages></addata></record> |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Attitude of Health Personnel Deoxyribonucleic acid DNA DNA - analysis DNA - blood DNA, Neoplasm - blood DNA, Neoplasm - isolation & purification Female Genetic counseling Genetic Counseling - methods Genetic Counseling - organization & administration Genetic Counseling - statistics & numerical data Genetic screening Genetic testing Guidelines Health Services Needs and Demand - organization & administration Health Services Needs and Demand - standards Health Services Needs and Demand - statistics & numerical data Humans Management Medical screening Patients Placenta Practice Patterns, Physicians' - standards Practice Patterns, Physicians' - statistics & numerical data Pregnancy Pregnancy Complications, Neoplastic - blood Pregnancy Complications, Neoplastic - diagnosis Pregnancy Complications, Neoplastic - genetics Prenatal Diagnosis - methods Prenatal Diagnosis - statistics & numerical data Referral and Consultation - statistics & numerical data Surveys and Questionnaires Truth Disclosure Tumor cells Tumors |
| title | Prenatal cfDNA screening results indicative of maternal neoplasm: survey of current practice and management needs |
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