Promoting Healthy People 2020 Genomics Objectives in Connecticut: Genetic Counseling and Testing for Hereditary Breast and Ovarian Cancer and Lynch Syndrome

Connecticut has some of the highest cancer incidence rates in the nation, including the second highest incidence rate for breast cancer. Implementing cancer genomics best practices for prevention and early detection has potential for significant public health impact. Healthy People (HP) 2020 contains a new Genomics topic area with two objectives: to increase the proportions of persons with newly diagnosed colorectal cancer who receive genetic testing to identify Lynch syndrome; and to increase the proportion of women with a family history of breast and/or ovarian cancer who receive genetic counseling. Achieving these objectives requires a provider workforce with knowledge of cancer genomics best practices. The Connecticut Department of Public Health Genomics Office conducted an HP 2020 Action Project comprising educational outreach to healthcare providers. The effort provided Connecticut's hospitals with facility-specific Tumor Registry data on diagnosed cancers suggestive of hereditary breast and ovarian cancer and Lynch syndromes; provided targeted hospital staff with evidence-based “best practice” recommendations for genetic counseling and testing, fact sheets, and resources; and offered hospitals a Grand Rounds training on cancer genomics best practices by Certified Genetics Counselors. A training was recorded and made available via TRAIN-CT, a Web-based learning management system. Surveys were conducted to assess anticipated changes in provider referral practices. Connecticut's HP 2020 Project is expected to help health care providers improve their referral practices and patient care, ultimately leading to better health outcomes. This approach might be a useful model for providing feedback to hospitals on other diseases/conditions reported to the State.