Ovarian cancer (OC) affects 1 in 69 Canadian women, with a five year survival rate of 44%.1 Based on existing literature, up to 20% of high grade serous ovarian cancers (HGSOC) are due to a germline mutation in an OC predisposing gene, most notably BRCA1 and BRCA2 (BRCA1/2).2 Identifying women with hereditary OC can provide opportunities for treatment, as well as facilitate the identification of at-risk relatives who may benefit from increased cancer surveillance and/or risk-reducing surgery. Previously, access to genetic testing for women with HGSOC treated at the MUHC required a referral from a gynecologic oncologist to Medical Genetics. Based on internal data, this referral-based approach led to untimely delays to genetic testing as well as a referral rate of 60%. In August 2017, we launched the Gynecologic Oncology Initiated Genetic Testing (GOIGT) protocol to improve the testing rate of women with hereditary OC. Women with HGSOC are now offered genetic testing as a standard component of their care at the MUHC, with testing facilitated by their gynecologist oncologist. A shared testing portal with Medical Genetics ensures the timely disclosure of test results to patients and the provision of genetic counselling. This collaborative approach has improved testing rates to 91.5%, decreased wait times for genetic testing, and facilitated the timely identification of at-risk relatives who may benefit from genetic counselling. It has also contributed to a decrease in the waiting list for pre-test genetic counselling in the cancer genetics clinic for patients with other indications for genetic assessment.
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