Genetic and genomic data are increasingly guiding clinical care for cancer patients. To meet the growing demand for precision medicine, patient-facing oncology staff will be a part of leading the provision of genomic testing. A scoping review was undertaken to identify the range of genetic and genomic learning needs of oncologists and oncology nurses. Learning needs were reported relating to interpretation of genomic data, clinical decision-making, patient communication and counseling, and fundamentals of genetics and genomics. There was a lack of empirical research specific to oncology nurses and their learning needs in tumor sequencing. Our findings suggest that oncologists and oncology nurses need tailored support, education and training to improve their confidence and skills in adopting genomic testing into clinical practice.

Keywords:

Papers of special note have been highlighted as: • of interest; •• of considerable interest

References

1. George A, Riddell D, Seal S et al. Implementing rapid, robust, cost-effective, patient-centred, routine genetic testing in ovarian cancer patients. Sci. Rep. 6, 29506 (2016).
MedlineGoogle Scholar
2. Percival N, George A, Gyertson J et al. The integration of BRCA testing into oncology clinics. Br. J. Nurs. 25(12), 690–694 (2016).
MedlineGoogle Scholar
3. Rumford M, Lythgoe M, Mcneish I et al. Oncologist-led BRCA ‘mainstreaming’ in the ovarian cancer clinic: a study of 255 patients and its impact on their management. Sci. Rep. 10, 3390 (2020).
Medline CASGoogle Scholar
4. Rahman B, Lanceley A, Kristeleit R et al. Mainstreamed genetic testing for women with ovarian cancer: first-year experience. J. Med. Genet. 56, 195–198 (2019).
MedlineGoogle Scholar
5. Hallowell N, Wright S, Stirling D, Gourley C, Young O, Porteous M. Moving into the mainstream: healthcare professionals' views of implementing treatment focussed genetic testing in breast cancer care. Fam. Cancer 18(3), 293–301 (2019).
MedlineGoogle Scholar
6. Calzone KA, Cashion A, Feetham S et al. Nurses transforming health care using genetics and genomics. Nurs. Outlook 58(1), 26–35 (2010).
MedlineGoogle Scholar
7. Scott N, O'sullivan J, Asgeirsson K, Macmillan D, Wilson E. Changing practice: moving to a specialist nurse-led service for BRCA gene testing. Br. J. Nurs. 29(10), S6–S13 (2020).
MedlineGoogle Scholar
8. Calzone K, Kirk M, Tonkin E, Badzek L, Benjamin C, Middleton A. Increasing nursing capacity in genomics: overview of existing global genomics resources. Nurse Educ. Today 69, 53–59 (2018).
MedlineGoogle Scholar
9. Wright H, Zhao L, Birks M, Mills J. Nurses' competence in genetics: an integrative review. Nurse Health Sci. 20(2), 142–153 (2018).
MedlineGoogle Scholar
10. Gray SW, Hicks-Courant K, Cronin A, Rollins BJ, Weeks JC. Physicians' attitudes about multiplex tumor genomic testing. J. Clin. Oncol. 32(13), 1317–1323 (2014). • One of the first articles exploring oncologists' perceived use and understanding of genomic tumor sequencing.
MedlineGoogle Scholar
11. Johnson LM, Valdez JM, Quinn EA et al. Integrating next-generation sequencing into pediatric oncology practice: an assessment of physician confidence and understanding of clinical genomics. Cancer 123(12), 2352–2359 (2017).
MedlineGoogle Scholar
12. Chow-White P, Ha D, Laskin J. Knowledge, attitudes, and values among physicians working with clinical genomics: a survey of medical oncologists. Hum. Resour. Health 15(1), 42 (2017).
MedlineGoogle Scholar
13. De Moor J, Gray S, Mitchell S, Klabunde C, Freedman A. Oncologist confidence in genomic testing and implications for using multimarker tumor panel tests in practice. JCO Precis. Oncol. 4, 620–631 (2020).
Google Scholar
14. Edelman E, Tanner P, Taber K et al. Provider engagement in precision oncology education: an exploratory analysis of online continuing medical education data. Pers. Med. 16(3), 199–209 (2013).
Google Scholar
15. Skirton H, Lewis C, Kent A, Coviello DA; Members of EuroGentest Committee. Genetic education and the challenge of genomic medicine: development of core competences to support preparation of health professionals in Europe. Eur. J. Hum. Genet. 18(9), 972–977 (2010).
MedlineGoogle Scholar
16. Hoxhaj I, Tognetto A, Acampora A, Stojanovic J, Boccia S. Core competencies in cancer genomics for healthcare professionals: results from a systematic literature review and a Delphi process. J. Cancer Educ. doi:10.1007/s13187-021-01956-w (2021). (Epub ahead of print) • Presents the most recent research relating to the competencies needed for undertaking cancer genomics by health professionals.
MedlineGoogle Scholar
17. Talwar D, Tseng T, Foster M, Xu L, Chen L. Genetics/genomics education for nongenetic health professionals: a systematic literature review. Genet. Med. 19(7), 725–732 (2017).
MedlineGoogle Scholar
18. Nisselle A, Martyn M, Jordan H et al. Ensuring best practice in genomic education and evaluation: a program logic approach. Front. Genet. 10, 1–13 (2019).
MedlineGoogle Scholar
19. Ha VTD, Frizzo-Barker J, Chow-White P. Adopting clinical genomics: a systematic review of genomic literacy among physicians in cancer care. BMC Med. Genomics 11(1), 18 (2018). •• Uses a theoretical model to define three types of knowledge. It also critiques outcomes of genomic educational interventions.
MedlineGoogle Scholar
20. Munn Z, Peters MDJ, Stern C, Tufanaru C, Mcarthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med. Res. Methodol. 18(1), 143 (2018).
MedlineGoogle Scholar
21. Tricco A, Lillie E, Zarin W et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann. Intern. Med. 169(7), 467–473 (2018).
MedlineGoogle Scholar
22. Peters MDJ, Marnie C, Tricco AC et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid. Syn. 18(10), 2119–2126 (2020).
MedlineGoogle Scholar
23. Genomics Education Programme. Facilitating genomic testing: a competency framework. www.genomicseducation.hee.nhs.uk/consent-a-competency-framework/
Google Scholar
24. Covidence Systematic Review Software. Veritas Health Innovation Melbourne, Australia. www.covidence.org
Google Scholar
25. Mchugh M. Interrater reliability: the kappa statistic. Biochem. Medica. 22, 276–282 (2012).
MedlineGoogle Scholar
26. Popay J, Roberts H, Sowden A et al. Guidance on the conduct of narrative synthesis in systematic reviews: a product from the ESRC methods programme (2006). www.lancaster.ac.uk/media/lancaster-university/content-assets/documents/fhm/dhr/chir/NSsynthesisguidanceVersion1-April2006.pdf
Google Scholar
27. Kmet L, Lee R, Cook L. Standard quality assessment criteria for evaluating primary research papers from a variety of fields (2004) www.ihe.ca/advanced-search/standard-quality-assessment-criteria-for-evaluating-primary-research-papers-from-a-variety-of-fields
Google Scholar
28. Beitsch PD, Whitworth PW. Can breast surgeons provide breast cancer genetic testing? An American Society of Breast Surgeons survey. Ann. Surg. Oncol. 21(13), 4104–4108 (2014).
MedlineGoogle Scholar
29. Bruinooge SS, Dueck AC, Gray SW et al. Use, attitudes, and perceptions of tumor genomic testing: Survey of TAPUR physicians. J. Clin. Oncol. 37(Suppl. 15), 6531 (2019).
Google Scholar
30. Chen A, Flaherty K, O'dwyer PJ et al. Tumor genomic profiling practices and perceptions: a survey of physicians participating in the NCI-MATCH trial. JCO Precis. Oncol. 4, 1207–1216 (2020).
Google Scholar
31. Choi MC, Lim MC, Lee M et al. Practice patterns of hereditary ovarian cancer management in Korea. Int. J. Gynecol. Cancer 27(5), 895–899 (2017).
MedlineGoogle Scholar
32. Dodson C. Knowledge and attitudes of oncology nurses regarding pharmacogenomic testing. Clin. J. Oncol. Nurs. 18(4), E64–70 (2014).
MedlineGoogle Scholar
33. Dodson C. Attitudes of oncology nurses concerning pharmacogenomics. Pers. Med. 12(6), 559–562 (2015).
CASGoogle Scholar
34. Dressler LG, Deal AM, Patel J, Markey J, Riper MV, Mcleod HL. Cancer pharmacogenomics, adoption by oncologists and patient benefit. Pers. Med. 11(2), 143–153 (2014).
CASGoogle Scholar
35. Eccles B, Copson E, Maishman T, Abraham J, Eccles D. Understanding of BRCA VUS genetic results by breast cancer specialists. BMC Cancer 15, 936 (2015).
Medline CASGoogle Scholar
36. Freedman AN, Klabunde CN, Wiant K et al. Use of next-generation sequencing tests to guide cancer treatment: results from a nationally representative survey of oncologists in the United States. JCO Precis. Oncol. (2), 1–13 (2018).
MedlineGoogle Scholar
37. Gingras I, Sonnenblick A, De Azambuja E et al. The current use and attitudes towards tumor genome sequencing in breast cancer. Sci. Rep. 6, 22517 (2016).
Medline CASGoogle Scholar
38. Gleeson M, Kentwell M, Meiser B et al. The development and evaluation of a nationwide training program for oncology health professionals in the provision of genetic testing for ovarian cancer patients. Gynecol. Oncol. 158(2), 431–439 (2020).
Medline CASGoogle Scholar
39. Gray S, Park E, Najita J et al. Oncologists' and cancer patients' views on whole-exome sequencing and incidental findings: results from the CanSeq study. Genet. Med. 18(10), 1011–1019 (2016).
Medline CASGoogle Scholar
40. Gray S, Gagan J, Cerami E et al. Interactive or static reports to guide clinical interpretation of cancer genomics. J. Am. Med. Inform. Assoc. 25(5), 458–464 (2018).
MedlineGoogle Scholar
41. Mcgill B, Wakefield C, Hetherington K et al. “Balancing expectations with actual realities”: conversations with clinicians and scientists in the first year of a high-risk childhood cancer precision medicine trial. J. Pers. Med. 10(1), 9 (2020).
Google Scholar
42. Schram A, Reales D, Galle J et al. Oncologist use and perception of large panel next-generation tumor sequencing. Ann. Oncol. 28(9), 2298–2304 (2017).
Medline CASGoogle Scholar
43. Seven M, Pasalak S, Guvenc G, Kok G. knowledge level and educational needs of Turkish oncology nurses regarding the genetics of hereditary breast and ovarian cancer. J. Contin. Educ. Nurs. 48(12), 570–576 (2017).
MedlineGoogle Scholar
44. Thavaneswaran S, Napier C, Goldstein D et al. Medical oncologists' experience with returning molecular tumor profiling to patients. J. Clin. Onc. 37, 10521 (2019).
Google Scholar
45. Van Riel E, Wárlám-Rodenhuis C, Verhoef S, Rutgers E, Ausems M. BRCA testing of breast cancer patients: medical specialists' referral patterns, knowledge and attitudes to genetic testing. Eur. J. Cancer Care 19(3), 369–376 (2010).
Medline CASGoogle Scholar
46. Weipert CM, Ryan KA, Everett JN et al. Physician experiences and understanding of genomic sequencing in oncology. J. Genet. Couns. 27(1), 187–196 (2018).
MedlineGoogle Scholar
47. Brusco LL, Wathoo C, Mills Shaw KR et al. Physician interpretation of genomic test results and treatment selection. Cancer 124(5), 966–972 (2018).
MedlineGoogle Scholar
48. Demeshko A, Pennisi DJ, Narayan S, Gray SW, Brown MA, Mcinerney-Leo AM. Factors influencing cancer genetic somatic mutation test ordering by cancer physician. J. Transl. Med. 18(1), 431 (2020).
Medline CASGoogle Scholar
49. Berger MF, Mardis ER. The emerging clinical relevance of genomics in cancer medicine. Nat. Rev. Clin. Oncol. 15(6), 353–365 (2018).
Medline CASGoogle Scholar
50. Burke W, Korngiebel D. Closing the gap between knowledge and clinical application: challenges for genomic translation. PLoS Genet. 11(2), e1004978 (2015).
MedlineGoogle Scholar
51. Deleonardis K, Hogan L, Cannistra S, Rangachari D, Tung N. When should tumor genomic profiling prompt consideration of germline testing? J. Oncol. Pract. 15(9), 465–473 (2019).
MedlineGoogle Scholar
52. Vorderstrasse AA, Hammer MJ, Dungan JR. Nursing implications of personalized and precision medicine. Semin. Oncol. Nurs. 30(2), 130–136 (2014).
MedlineGoogle Scholar
53. Robson M, Bradbury A, Arun B et al. American Society of Clinical Oncology policy statement update: genetic and genomic testing for cancer susceptibility. J. Clin. Oncol. 33(31), 3660–3367 (2015).
Medline CASGoogle Scholar
54. Hoskins PJ. Inadequate rates of BRCA testing with its negative consequences for women with epithelial ovarian cancer and their families: an overview of the literature. Clin. Oncol. 30(8), 472–483 (2018).
CASGoogle Scholar
55. Nisselle A, Janinski M, Martyn M et al. Ensuring best practice in genomics education and evaluation: reporting item standards for education and its evaluation in genomics (RISE2 Genomics). Genet. Med. 23, 1356–1365 (2021). •• Describes the recommended minimum set of information to guide consistent and robust development of genomic educational interventions.
MedlineGoogle Scholar

Vol. 19, No. 2

Supplemental Materials

Metrics

Downloaded 351 times

History

Received 20 July 2021

Accepted 12 November 2021

Published online 21 January 2022

Published in print March 2022

Information

Keywords

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/pme-2021-0096

Author contributions

B Rahman: Substantial contributions to the acquisition, analysis and interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. A McEwen, J Phillips, K Tucker and D Goldstein: Drafting the work or revising it critically for important intellectual content; final approval of the version to be published. C Jacobs: Substantial contributions to the conception or design of the work; acquisition, analysis and interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Financial & competing interests disclosure

This work was funded by the Translational Centre Research Network, a translational cancer research centre programme funded by the Cancer Institute NSW. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Data sharing statement

Data sharing is not applicable to this article as no new data were created or analyzed in this paper.

PDF download