Prenatal cfDNA screening results indicative of maternal neoplasm: survey of current practice and management needs

Prenat Diagn. 2017 Feb;37(2):126-132. doi: 10.1002/pd.4973. Epub 2016 Dec 16.

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.

MeSH terms

  • Attitude of Health Personnel*
  • DNA / analysis
  • DNA / blood
  • DNA, Neoplasm / blood
  • DNA, Neoplasm / isolation & purification*
  • Female
  • Genetic Counseling* / methods
  • Genetic Counseling* / organization & administration
  • Genetic Counseling* / statistics & numerical data
  • Health Services Needs and Demand* / organization & administration
  • Health Services Needs and Demand* / standards
  • Health Services Needs and Demand* / statistics & numerical data
  • Humans
  • 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

Substances

  • DNA, Neoplasm
  • DNA