Practices and perspectives of genetic counselors about high-risk pancreatic cancer screening: A cross-sectional survey study

Surveillance of individuals at high-risk of pancreatic cancer using CAPS criteria and other expert consensus guidelines may result in earlier pancreatic cancer detection in some cases; therefore, clinicians are responsible for appropriately identifying and referring these individuals to appropriate high-risk pancreas cancer screening programs. This study aimed at assessing the perspective, knowledge, and clinical practices of cancer genetic counselors surveyed nationwide towards identification of individuals at high-risk of pancreatic cancer and utilization of high-risk pancreatic cancer screening programs. One hundred and eighty-nine genetic counselors who listed "Cancer" as their specialty on the NSGC website responded to the survey, which consisted of multiple practice-based, knowledge-based, and clinical vignette-based questions. Almost 70% of the genetic counselors surveyed accurately identified when an individual would be considered for high-risk pancreatic cancer screening, when using 2019 CAPS consensus guidelines as a benchmark. Access to high-risk pancreatic cancer screening programs and increased provider comfort in counseling individuals at high-risk of pancreatic cancer were found to be statistically associated in accurate identification of high-risk individuals in three of the clinical vignettes. Additionally, 60% of genetic counselors reported the majority of high-risk individuals accept a referral for pancreatic cancer screening, which shows a high uptake of patients accepting referrals from genetic counselors. Genetic counselors have high accuracy in determining who is eligible for high-risk pancreas screening; thus, they are the ideal providers for initiating referrals to high-risk pancreatic cancer screening programs. Genetic counseling programs and high-risk pancreatic cancer screening programs should establish a close working relationship to optimize the identification and subsequent referrals of high-risk individuals eligible for pancreas cancer screening.