Genetic evaluations and testing results for hereditary colon and uterine cancer syndrome in a community oncology setting.

312 Background: Genetic evaluation and genetic testing for individuals with a significant personal and/or family cancer history is recommended by the National Comprehensive Cancer Network (NCCN) and other professional societies. The NCCN outlines criteria for germline testing for Lynch syndrome caused by mutations in MLH1, MSH2, MSH6, PMS2, and EPCAM based on personal and family history. There are subtypes of cancer patients that automatically qualify for Lynch syndrome genetic testing based on personal history including: colon or rectal cancer diagnosed <51 and endometrial cancer diagnosed <51. Actkins et al (2021) reported that genetic testing occurred in only 14.4% of their patients diagnosed with colon and endometrial cancer under 51. It is our hypothesis that the Texas Oncology community-based genetics program has evaluation and testing rates exceeding published reports. Methods: A retrospective cohort study of individuals diagnosed at all Texas Oncology sites between January 1, 2022, through December 31, 2022. Individuals with colon or rectal cancer diagnosed < 51 years of age and individuals diagnosed with endometrial cancer <51 years of age were included. Data was obtained from electronic medical records. The project was approved by the Texas Oncology Privacy Board. Results: A total of 869 patients were included in the study cohort. 417 (48%) underwent genetic testing without a formal genetics’ evaluation and 325 (37%) had a genetic evaluation in addition to genetic testing. 294/325 (90%) had their genetic evaluation at a Texas Oncology clinic. The most common reason for no genetic testing in this cohort was the physician not ordering the testing (79%). There was not a statistical difference in testing rates based on race, gender, or if the Texas Oncology site had a genetics provider in the clinic. Conclusions: 100% of our cohort qualified for genetic testing and only 48% received genetic testing. While this study proves that community-based oncology clinics can surpass published genetic testing rates, there are still quality improvement measures that can be implemented to increase genetic testing rates in this cohort. Colon or Rectal <51 Uterine <51 Had germline genetic testing 312 (51.4%) 105 (40%) Had genetic evaluation 234 (39%) 91 (35%) Genetic evaluation at TXO 213 (91%) 81 (89%) If seen at GREAT site, more likely to get tested? No (p=0.1969) No (p=0.9353)