Community Health Worker (CHW) – Supported Hereditary Cancer Risk Assessment and Genetic Testing Program

About the Program

Category: Health (Best in Category)

Year: 2023

We implemented a community health worker (CHW)-supported genetic cancer risk assessment and testing pilot program in January 2020 at Los Angeles County Department of Health Services/Olive View-UCLA Medical Center. We created and administered an original National Comprehensive Cancer Network (NCCN)-based hereditary cancer risk questionnaire to patients in our specialty gynecology and women’s health primary care clinics serving >70% predominantly Spanish-speaking LatinX patients. Patients meeting high-risk criteria were offered video-based genetic education and testing. Patients were notified of results via telehealth and offered counseling as indicated. In the first 18 months, 940 patients were screened through the pilot program: 196 were identified as high risk, 103 patients were tested, and pathogenic variants were identified in 10 (10%), only 2 of whom had a personal cancer history. This compares favorably to the 73 and 68 patients who were tested per usual practice through our certified genetic counselor (CGC) during the pilot program and the 18 months prior respectively, over 80% of whom had a personal cancer history. The CHW program led to a significant increase in education and testing among high-risk patients with no personal cancer history (70% vs. 25%). This program enables us to avail family history-based hereditary cancer testing to many more unaffected individuals allowing for individualized patient education, and implementation of cancer prevention strategies before the patient develops cancer.