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. 2023 May 26:13:1140135.
doi: 10.3389/fonc.2023.1140135. eCollection 2023.

A mainstreaming oncogenomics model: improving the identification of Lynch syndrome

Rosie O'Shea  1 , Ashley Crook  2 , Chris Jacobs  2 , Maira Kentwell  3   4 , Margaret Gleeson  5 , Katherine M Tucker  6 , Heather Hampel  7 , Alanna Kulchak Rahm  8 , Natalie Taylor  1   9 , Sarah Lewis  1 , Nicole M Rankin  1   10
Affiliations

A mainstreaming oncogenomics model: improving the identification of Lynch syndrome

Rosie O'Shea et al. Front Oncol. .

Abstract

Introduction: "Mainstreaming" is a proposed strategy to integrate genomic testing into oncology. The aim of this paper is to develop a mainstreaming oncogenomics model by identifying health system interventions and implementation strategies for mainstreaming Lynch syndrome genomic testing.

Methods: A rigorous theoretical approach inclusive of conducting a systematic review and qualitative and quantitative studies was undertaken using the Consolidated Framework for Implementation Research. Theory-informed implementation data were mapped to the Genomic Medicine Integrative Research framework to generate potential strategies.

Results: The systematic review identified a lack of theory-guided health system interventions and evaluation for Lynch syndrome and other mainstreaming programs. The qualitative study phase included 22 participants from 12 health organizations. The quantitative Lynch syndrome survey included 198 responses: 26% and 66% from genetic and oncology health professionals, respectively. Studies identified the relative advantage and clinical utility of mainstreaming to improve genetic test access and to streamline care, and adaptation of current processes was recognized for results delivery and follow-up. Barriers identified included funding, infrastructure and resources, and the need for process and role delineation. The interventions to overcome barriers were as follows: embedded mainstream genetic counselors, electronic medical record genetic test ordering, results tracking, and mainstreaming education resources. Implementation evidence was connected through the Genomic Medicine Integrative Research framework resulting in a mainstreaming oncogenomics model.

Discussion: The proposed mainstreaming oncogenomics model acts as a complex intervention. It features an adaptable suite of implementation strategies to inform Lynch syndrome and other hereditary cancer service delivery. Implementation and evaluation of the model are required in future research.

Keywords: Lynch syndrome; mainstreaming; oncogenomics model; oncology service delivery; routine genetic testing.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study design flow for the Mainstreaming OncoGenomics mOdel (MOGO).
Figure 2
Figure 2
The GMIR-informed mainstreaming oncology genomics model for LS and other GT mainstreaming service delivery in oncology care.
See this image and copyright information in PMC

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