IGNITE-TX (Identifying Individuals for Genetic Testing & Treatment) intervention
Description: Hereditary breast and ovarian cancer (HBOC) and Lynch syndrome (LS) are inherited syndromes that significantly increase the risk for an individual to develop cancer during their lifetime. Individuals with HBOC and LS are recommended to complete early, more frequent cancer screening and may consider risk-reducing surgery (such as mastectomy) to decrease the chance of developing cancer. Cascade genetic testing (CGT) is an efficient, targeted approach to identify individuals at risk for HBOC and LS. CGT is the process of offering genetic counseling and genetic testing to the at-risk relatives (ARR) of an individual found to have HBOC or LS (proband). Current studies estimate that probands communicate their HBOC or LS diagnosis to 80% of their ARRs, but only 15–51% of ARRs complete genetic testing to determine if they have inherited HBOC/LS, which suggests that barriers exist for ARRs as they apply this information to their own decision-making and health behaviors. Efforts to support families with HBOC and LS are needed, given the low rates of CGT and the significant opportunity to prevent cancer-related morbidity and mortality in healthy ARRs. The Centers for Disease Control and Prevention have determined that efforts to increase detection of HBOC and LS have significant potential for positive impacts on public health, and these syndromes are prioritized for population-level intervention.
The overall goal of the study is to engage and support a diverse population to maximize the identification of probands and their ARRs and overcome barriers to CGT through the IGNITE-TX (Identifying Individuals for Genetic Testing & Treatment) intervention. IGNITE-TX seeks to support families with HBOC and LS by providing 1) assistance to probands in effective identification of, and communication with, ARRs; 2) education about HBOC, LS, and CGT as a pathway to cancer prevention; 3) patient navigation services to support access to existing CGT resources by developing an individualized plan; and 4) systematic tracking of CGT. To evaluate IGNITE-TX, we will conduct a randomized controlled trial with probands allocated to one of four interventions: 1) usual care, 2) free genetic counseling and testing, 3) IGNITE-TX, and 4) IGNITE-TX + free genetic counseling and testing.
Despite national guidelines recommending CGT and the Centers for Disease Control and Prevention prioritizing identification of ARRs with HBOC and LS, efforts to increase the detection of ARRs with HBOC and LS have not been implemented beyond individual academic medical center or laboratory settings. IGNITE-TX seeks to improve rates of CGT through education and navigation. With CGT access optimized, we will be well positioned to move beyond identifying ARRs to developing strategies for cancer prevention such as improving access to indicated screening, chemoprevention, and/or risk-reducing surgery. After demonstrating feasibility and impact, our model could be implemented in other geographic environments to support statewide and national efforts to increase CGT and promote cancer prevention.
Funder: American Cancer Society
Amount: $300,000
Funding type: award
Start date: 2024-01-01
End date: 2025-12-31
Investigator: Jose Alejandro Rauh-Hain
Institution: University of Texas M.D. Anderson Cancer Center
Subfield: Genetics
Domain: Life Sciences
Funded outputs count: 0
Funder award ID: AHEAD-DBG-23-1143580-01-CPSH
OpenAlex ID: G8395937689