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Trevisan L, Godino L, Battistuzzi L, Innella G, Luppi E, Buzzatti G, Gismondi V, Blondeaux E, Bonelli LA, Turchetti D, Varesco L. Cascade testing in Italian Hereditary Breast Ovarian Cancer families: a missed opportunity for cancer prevention? Fam Cancer 2024; 23:197-207. [PMID: 37968543 DOI: 10.1007/s10689-023-00349-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/24/2023] [Indexed: 11/17/2023]
Abstract
Healthy carriers of BRCA1/2 pathogenic variants (PVs) may benefit from risk-reducing measures of proven efficacy. The main approach to identify these individuals is cascade testing, and strategies to support this complex process are under investigation. In Italy, cascade testing has received little attention; therefore, we analyzed the uptake and characteristics of BRCA1/2 cascade testing in families diagnosed with HBOC between 2017 and 2019 at two Italian genetics centers. All blood relatives aged 18 years or older at September 2022 and who could be involved in the first step of cascade testing (i.e., all the living relatives closest to the proband) were included. In addition to first-degree relatives, individuals who were second-, third- or fourth-degree relatives were included if the closest relative(s) was/were deceased. Overall, 213 families were included (103, Genoa; 110, Bologna). Most probands were women affected by breast and/or ovarian cancer (86.4%, Genoa; 84.5%, Bologna), and the branch segregating the PV was known/suspected in 62% of families (62.1%, Genoa; 60.9%, Bologna). Overall, the uptake of cascade testing was 22.8% (25.8%, Genoa; 19.9%, Bologna; OR = 0.59: 95%CI 0.43-0.82). It was strongly associated with female gender (OR = 3.31, 95%CI 2.38-4.59), age ≤ 70 years (< 30 years OR = 3.48, 95%CI 1.85-6.56; 30-70 years OR = 3.08, 95%CI 2.01-4.71), first-degree relationship with the proband (OR = 16.61, 95%CI 10.50-26.28) and segregation of the PV in both the maternal (OR = 2.54, 95%CI 1.72-3.75) and the paternal branch (OR = 4.62, 95%CI 3.09-6.91). These real-world data may be important to inform the design and implementation of strategies aimed at improving the uptake of HBOC cascade testing in Italy.
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Affiliation(s)
- Lucia Trevisan
- Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lea Godino
- Unit of Medical Genetics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Linda Battistuzzi
- Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni Innella
- Unit of Medical Genetics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Elena Luppi
- Unit of Medical Genetics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Giulia Buzzatti
- Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Viviana Gismondi
- Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Eva Blondeaux
- U.O. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genova, 16132, Italy.
| | - Luigina Ada Bonelli
- U.O. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genova, 16132, Italy
| | - Daniela Turchetti
- Unit of Medical Genetics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Liliana Varesco
- Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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2
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Georgiou D, Monje-Garcia L, Miles T, Monahan K, Ryan NAJ. A Focused Clinical Review of Lynch Syndrome. Cancer Manag Res 2023; 15:67-85. [PMID: 36699114 PMCID: PMC9868283 DOI: 10.2147/cmar.s283668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/23/2022] [Indexed: 01/19/2023] Open
Abstract
Lynch syndrome (LS) is an autosomal dominant condition that increases an individual's risk of a constellation of cancers. LS is defined when an individual has inherited pathogenic variants in the mismatch repair genes. Currently, most people with LS are undiagnosed. Early detection of LS is vital as those with LS can be enrolled in cancer reduction strategies through chemoprophylaxis, risk reducing surgery and cancer surveillance. However, these interventions are often invasive and require refinement. Furthermore, not all LS associated cancers are currently amenable to surveillance. Historically only those with a strong family history suggestive of LS were offered testing; this has proved far too restrictive. New criteria for testing have recently been introduced including the universal screening for LS in associated cancers. This has increased the number of people being diagnosed with LS but has also brought about unique challenges such as when to consent for germline testing and questions over how and who should carry out the consent. The results of germline testing for LS can be complicated and the diagnostic pathway is not always clear. Furthermore, by testing only those with cancer for LS we fail to identify these individuals before they develop potentially fatal pathology. This review will outline these challenges and explore solutions. Furthermore, we consider the potential future of LS care and the related treatments and interventions which are the current focus of research.
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Affiliation(s)
- Demetra Georgiou
- Genomics and Personalised Medicine Service, Charing Cross Hospital, London, UK
| | - Laura Monje-Garcia
- The St Mark's Centre for Familial Intestinal Cancer Polyposis, St Mark's Hospital, London, UK.,School of Public Health, Imperial College, London, UK
| | - Tracie Miles
- South West Genomics Medicine Service Alliance, Bristol, UK
| | - Kevin Monahan
- The St Mark's Centre for Familial Intestinal Cancer Polyposis, St Mark's Hospital, London, UK.,Department of Gastroenterology, Imperial College, London, UK
| | - Neil A J Ryan
- Department of Gynaecological Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK.,The College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
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3
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Vibert R, Lahlou-Laforêt K, Samadi M, Krivosic V, Blanc T, Amar L, Burnichon N, Abadie C, Richard S, Gimenez-Roqueplo AP. Minors at risk of von Hippel-Lindau disease: 10 years' experience of predictive genetic testing and follow-up adherence. Eur J Hum Genet 2022; 30:1171-1177. [PMID: 35918537 PMCID: PMC9553881 DOI: 10.1038/s41431-022-01157-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/08/2022] [Accepted: 07/13/2022] [Indexed: 12/15/2022] Open
Abstract
Von Hippel-Lindau (VHL) disease is one of the most common cancer predisposition syndromes. Penetrance is high with around 20% of children presenting detectable and curable manifestations of the disease at 15 years old. VHL predictive genetic testing (PGT) is recommended during childhood from age 5 years in France. Insufficient compliance to surveillance of VHL pathogenic variant (PV) carriers is associated with severe outcome. PGT experienced by children and their parents is probably critical in influencing future acceptance of the result and adherence to surveillance. We conducted a retrospective study on minors tested (aged 5 to 16 years old) from 2010 to 2020, in a multidisciplinary oncogenetics consultation which follows a 3-step protocol based on psychological familial support. The objectives were to assess the adherence to follow-up within the National Expert Center for inherited predispositions to renal tumors (PREDIR) network of VHL PV carriers and its benefit through tumor detection and medical interventions. A VHL PGT was carried out in 34 children. Among the 16 children diagnosed as VHL PV carriers addressed to the PREDIR network, none had discontinued surveillance after a median of 41 months. Follow-up examinations detected 11 tumors in 6 children, 4 have been surgically treated. All had a favorable outcome. Our data suggest that a specific and adapted procedure for PGT in at-risk VHL children as well as a follow-up, organized within a specialized expert network, fosters a complete adherence to the surveillance protocol and thus lead to a favorable clinical outcome.
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Affiliation(s)
- Roseline Vibert
- Département de Médecine Génomique des Tumeurs et Cancers/UF Oncogénétique Tumeurs et Cancers Rares, AP-HP, Hôpital européen Georges Pompidou, F-75015, Paris, France
| | - Khadija Lahlou-Laforêt
- Université Paris Cité, AP-HP, Hôpital Européen Georges Pompidou, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, F-75015, Paris, France
- Réseau National pour Cancers Rares de l'Adulte PREDIR labellisé par l'Institut National du Cancer (INCa), AP-HP, Hôpital Bicêtre, 94270, Le Kremlin-Bicêtre, France
| | - Maryam Samadi
- Réseau National pour Cancers Rares de l'Adulte PREDIR labellisé par l'Institut National du Cancer (INCa), AP-HP, Hôpital Bicêtre, 94270, Le Kremlin-Bicêtre, France
| | - Valérie Krivosic
- Réseau National pour Cancers Rares de l'Adulte PREDIR labellisé par l'Institut National du Cancer (INCa), AP-HP, Hôpital Bicêtre, 94270, Le Kremlin-Bicêtre, France
- Service d'Ophtalmologie, AP-HP, Hôpital Lariboisière, F-75010, Paris, France
| | - Thomas Blanc
- Service de Chirurgie Viscérale et Urologie Pédiatrique, AP-HP, Hôpital Necker-Enfants Malades, F-75015, Paris, France
| | - Laurence Amar
- Réseau National pour Cancers Rares de l'Adulte PREDIR labellisé par l'Institut National du Cancer (INCa), AP-HP, Hôpital Bicêtre, 94270, Le Kremlin-Bicêtre, France
- Service d'Hypertension Artérielle, AP-HP, Hôpital européen Georges Pompidou, F-75015, Paris, France
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Nelly Burnichon
- Département de Médecine Génomique des Tumeurs et Cancers/UF Oncogénétique Tumeurs et Cancers Rares, AP-HP, Hôpital européen Georges Pompidou, F-75015, Paris, France
- Réseau National pour Cancers Rares de l'Adulte PREDIR labellisé par l'Institut National du Cancer (INCa), AP-HP, Hôpital Bicêtre, 94270, Le Kremlin-Bicêtre, France
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Caroline Abadie
- Réseau National pour Cancers Rares de l'Adulte PREDIR labellisé par l'Institut National du Cancer (INCa), AP-HP, Hôpital Bicêtre, 94270, Le Kremlin-Bicêtre, France
- Unité d'Oncogénétique, Institut de Cancérologie de l'Ouest, F-44800, Saint-Herblain, France
| | - Stéphane Richard
- Réseau National pour Cancers Rares de l'Adulte PREDIR labellisé par l'Institut National du Cancer (INCa), AP-HP, Hôpital Bicêtre, 94270, Le Kremlin-Bicêtre, France
- EPHE, PSL Université, 75015 Paris, and CNRS UMR 9019, Gustave Roussy, Université Paris-Saclay, 94800, Villejuif, France
| | - Anne-Paule Gimenez-Roqueplo
- Département de Médecine Génomique des Tumeurs et Cancers/UF Oncogénétique Tumeurs et Cancers Rares, AP-HP, Hôpital européen Georges Pompidou, F-75015, Paris, France.
- Réseau National pour Cancers Rares de l'Adulte PREDIR labellisé par l'Institut National du Cancer (INCa), AP-HP, Hôpital Bicêtre, 94270, Le Kremlin-Bicêtre, France.
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France.
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Bertonazzi B, Turchetti D, Godino L. Outcomes of support groups for carriers of BRCA 1/2 pathogenic variants and their relatives: a systematic review. Eur J Hum Genet 2022; 30:398-405. [PMID: 35082397 PMCID: PMC8989997 DOI: 10.1038/s41431-022-01044-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 01/14/2023] Open
Abstract
People tested positive for BRCA1/2 face an increased risk of cancer; to help them cope with the genetic information received, support to BRCA1/2 families should be continued after testing. Nonetheless how such support should be provided has not been established yet. As a potentially valuable option is represented by support groups, the aim of this systematic review was to assess studies exploring the outcomes of support groups for BRCA1/2 carriers. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42021238416). Peer-reviewed papers published between January 1995 and February 2021 were searched for, using four databases. Among 1586 records identified, 34 papers were reviewed in full-text and eleven were included in the qualitative synthesis of the results. Three themes emerged as major focuses of support groups: risk management decisions, family dynamics and risk communication, and psychosocial functioning. Our findings show that support groups proved helpful in supporting women's decision-making on risk-reducing options. Moreover, during those interventions, BRCA1/2 carriers had the opportunity to share thoughts and feelings, and felt that mutual support through interacting with other mutation carriers help them release the emotional pressure. However, no significant impact was reported in improving family communication. Overall, a high level of satisfaction and perceived helpfulness was reported for support group. The findings suggest that support groups represent a valuable tool for improving BRCA1/2 families care.
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Affiliation(s)
- Benedetta Bertonazzi
- U.O.C. Genetica Medica, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Daniela Turchetti
- U.O.C. Genetica Medica, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
- Centro di Ricerca sui Tumori Ereditari, Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
| | - Lea Godino
- U.O.C. Genetica Medica, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Centro di Ricerca sui Tumori Ereditari, Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
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5
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Lahlou-Laforêt K, Vibert R, Richard S, Gimenez-Roqueplo AP. Test génétique présymptomatique chez les mineurs à risque pour la maladie de von Hippel-Lindau et surveillance des porteurs de mutation — Aspects psychologiques et éthiques. PSYCHO-ONCOLOGIE 2022. [DOI: 10.3166/pson-2022-0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Les tests génétiques présymptomatiques chez les sujets mineurs soulèvent un questionnement éthique. Dans cet article, nous décrivons le protocole de test génétique présymptomatique de la consultation multidisciplinaire des cancers rares de l’hôpital européen Georges-Pompidou. Nous rapportons les résultats d’une étude rétrospective réalisée sur une population de 20 sujets mineurs à risque pour la maladie de von Hippel-Lindau, testés à notre consultation et adressés au centre de référence de la maladie (centre PREDIR). Les objectifs étaient d’évaluer la compliance au suivi et le bénéfice effectif de la surveillance. Les résultats montrent une compliance totale sur la durée du suivi et confirment le bénéfice médical du test présymptomatique, qui est associé au dépistage effectif des tumeurs.
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6
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Godino L, Turchetti D, Jackson L, Hennessy C, Skirton H. Genetic counselling as a route to enhanced autonomy: using a sequential mixed methods research approach to develop a theory regarding presymptomatic genetic testing for young adults at risk of inherited cancer syndromes. J Community Genet 2021; 12:685-691. [PMID: 34415557 DOI: 10.1007/s12687-021-00548-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022] Open
Abstract
Undertaking presymptomatic or predictive genetic testing should involve a considered choice. Decisions regarding genetic testing for young adults have to be considered within the context of their key life stage, which may involve developing a career, forming partnerships and/or becoming parents. The aim of this study was to develop a theoretical model regarding the factors involved when young adults (18-30 years) undergo presymptomatic genetic testing for inherited cancer syndromes. The model evolved from synthesis of results of a sequential mixed methods study involving a systematic review, a qualitative study and a quantitative study. The resulting model shows that young adults at risk of inherited cancer syndromes are influenced by others to have testing and come to counselling with their decision already made. However, genetic counselling enhances their feelings of autonomy and integration of their genetic status into their lives. Our theoretical model could be a valid support during the genetic counselling process for young adults and their parents, as it may sensitise professionals to the specific needs of this population, including education and support to autonomous decision-making. Counselling approaches should be modified in this population: an inclusive, multi-step counselling process is needed, with timing and setting set according to the specific features of this sensitive population.
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Affiliation(s)
- Lea Godino
- Division of Medical Genetics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. .,School of Nursing and Midwifery, Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK. .,Department of Medical and Surgical Sciences, Center for Studies on Hereditary Cancer, University of Bologna, Bologna, Italy.
| | - Daniela Turchetti
- Division of Medical Genetics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Leigh Jackson
- School of Nursing and Midwifery, Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK
| | | | - Heather Skirton
- School of Nursing and Midwifery, Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK
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7
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Turchetti D, Battistuzzi L, Bertonazzi B, Godino L. Sudden shift to remote genetic counseling during the COVID-19 pandemic: Experiences of genetics professionals in Italy. J Genet Couns 2021; 30:1024-1037. [PMID: 34096134 PMCID: PMC8242797 DOI: 10.1002/jgc4.1441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/28/2021] [Accepted: 05/01/2021] [Indexed: 11/11/2022]
Abstract
The 2020 COVID‐19 pandemic has rendered in‐person provision of genetic counseling impossible for prolonged periods in many countries, mandating a sudden shift to remote delivery. We used qualitative thematic analysis to explore Italian genetics professionals’ experience with remote genetic counseling. Fourteen group and four individual interviews were conducted after participants had delivered one or more remote sessions via videoconference or on the telephone. Data were coded and grouped under themes. Three main themes were identified as follows: (a) technical and logistical issues, (b) communication issues, and (c) clinical content and outcome of the session. The participants acknowledged that not having to travel to the clinic saves consultands time and expense. They also highlighted that not sharing a physical space with consultands and having to rely on technology can negatively impact on effective communication, building trusting relationships, and performing accurate psychosocial assessments. Regarding the clinical content of sessions, remote genetic counseling was perceived to favor greater focus and succinct, to the point communication. However, participants also felt uncomfortable not being able to use visual aids to support the explanation of complex concepts. Moreover, demographics and the socio‐cultural status of consultands emerged as factors influencing the outcome of remote genetic counseling sessions. Finally, participants reported feeling that more experience with this novel approach would improve their confidence and their ability to adapt their counseling skills as appropriate. Based on these findings, we suggest that effective, equitable provision of remote genetic counseling will require an infrastructure that is able to support video counseling, sharing of clinical documents and visual aids, and connect with a wide range of devices. Moreover, the structure of sessions should be tailored to the specific requirements of remote genetic counseling and suitable training efforts should be promoted to enhance professionals’ communication skills.
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Affiliation(s)
- Daniela Turchetti
- Dipartimento di Scienze Mediche e Chirurgiche, Centro di Ricerca sui Tumori Ereditari, Università di Bologna, Bologna, Italy.,UO Genetica Medica, IRCCS AOU Policlinico di S. Orsola, Bologna, Italy
| | - Linda Battistuzzi
- Dipartimento di Informatica, Bioingegneria, Robotica e Ingegneria dei Sistemi, Università degli Studi di Genova, Genova, Italy
| | - Benedetta Bertonazzi
- Dipartimento di Scienze Mediche e Chirurgiche, Centro di Ricerca sui Tumori Ereditari, Università di Bologna, Bologna, Italy
| | - Lea Godino
- Dipartimento di Scienze Mediche e Chirurgiche, Centro di Ricerca sui Tumori Ereditari, Università di Bologna, Bologna, Italy.,UO Genetica Medica, IRCCS AOU Policlinico di S. Orsola, Bologna, Italy
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8
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Bracci R, Gasperini B, Capalbo M, Campanelli T, Caimmi E, Mattioli R, Espinosa E, Prospero E. How to improve the identification of patients with cancer eligible for genetic counselling? Eur J Cancer Care (Engl) 2020; 29:e13276. [DOI: 10.1111/ecc.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 02/09/2020] [Accepted: 04/16/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Raffaella Bracci
- Oncology Unit Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Beatrice Gasperini
- Geriatric Unit Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Maria Capalbo
- Direzione Generale Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Tamara Campanelli
- Oncology Unit Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Eleonora Caimmi
- Section of Hygiene Department of Biomedical Sciences Università Politecnica delle Marche Ancona Italy
| | - Rodolfo Mattioli
- Oncology Unit Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Emma Espinosa
- Geriatric Unit Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Emilia Prospero
- Section of Hygiene Department of Biomedical Sciences Università Politecnica delle Marche Ancona Italy
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Forbes Shepherd R, Werner-Lin A, Keogh LA, Delatycki MB, Forrest LE. “I need to know if I’m going to die young”: Adolescent and young adult experiences of genetic testing for Li–Fraumeni syndrome. J Psychosoc Oncol 2020; 39:54-73. [DOI: 10.1080/07347332.2020.1768199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Rowan Forbes Shepherd
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Allison Werner-Lin
- School of Social Policy and Practice, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Louise A. Keogh
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Martin B. Delatycki
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Victorian Clinical Genetics Service, Parkville, Victoria, Australia
| | - Laura E. Forrest
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
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10
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Health professionals’ practice for young people with, or at risk of, Li–Fraumeni syndrome: An Australasian survey. J Genet Couns 2019; 29:737-747. [DOI: 10.1002/jgc4.1199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022]
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