Telephone Genetic Counseling for Hereditary Cancer Risk: Does Race Impact Outcomes?

Researchers investigated the use of telephone versus in-person genetic counseling for hereditary cancer risk and sough to identify patient-specific predictors of differential outcomes of telemedicine versus standard care.

“Telegenetics has become the predominant mode of cancer genetic counseling during the COVID-19 pandemic,” the study authors wrote in their study, which was published in the Journal of Telemedicine and Telecare.

For this study, researchers analyzed post-counseling (pre-result disclosure) data from a randomized noninferiority trial of 669 patients, evaluating telephone counseling versus standard genetic counseling. From the original cohort, 600 participants completed pre-test counseling, and 568 completed a two-week follow-up assessment prior to receiving their results.

“In this analysis,” the authors noted, “we focused on genetic counseling outcomes (knowledge, decisional conflict, and distress).” They used multivariate models to control for bivariate predictors of outcomes, and tested their hypothesis that pre-counseling numeracy, perceived stress, and race/ethnicity would impact telegenetics outcomes compared with standard care.

According to the results, numeracy was the only factor significantly associated with mode of genetic counseling and outcomes. Patients with higher numeracy demonstrated higher post-counseling knowledge after their telephone counseling (P<0.001), but this association was not found for standard care patients (P=0.450).

Additionally, numeracy was also associated with psychological outcomes. Participants with higher numeracy reported lower levels of distress in the telephone group (P=0.009), but not in the standard care group (P=0.16).

The researchers noted that race and/or ethnicity were not significantly related to differential outcomes in telephone versus standard genetic counseling (P>0.20). Perceived stress was also not a predictor of differential outcomes, the researchers noted.

“Although high numeracy was associated with higher levels of knowledge following telegenetic counseling, we did not identify any clinically significant patient-level contraindicators for telegenetic counseling,” wrote the authors in summary. “These results lend further confidence to the broad use of telegenetics.”