For patients with gynecologic cancers, unmet social needs are associated with distress and treatment interruption, according to a study published in Cancer. Researchers conducted a prospective, survey-based cohort study of patients who participated in a performance-improvement initiative offering assessment of social needs and screening for distress. The correlations among social needs, distress, and treatment outcomes were examined in a largely immigrant population of patients with gynecologic cancer (135 women). The study team found that 65.2% of women had at least one unmet social need, and 36.3% screened positive for distress. The most frequently reported need was help reading hospital materials (30.4%). Associations were observed for social isolation and lack of safety at home with distress (ORs, 3.65 and 4.90, respectively). Perceived lack of finances for medical care and lack of transportation correlated with nonadherence-related treatment interruption (ORs, 5.69 and 20.5, respectively), while interruption because of comorbidities or treatment-related toxicities was seen in association with positive distress scores (OR, 20.5). “In the future, we plan to demonstrate the utility and cost effectiveness of identified social need intervention algorithms not only for improving quality of life and health outcomes, but also for reducing health care disparities,” a coauthor said in a statement.
Genetic Testing Recommended for Women Aged 65+ With Breast Cancer
Women older than 65 with estrogen receptor (ER)-negative breast cancer and perhaps all older women with breast cancer should be offered hereditary breast cancer testing, according to a study published in the Journal of Clinical Oncology. Investigators sought to estimate the frequency of pathogenic variants (PVs) and remaining risks for breast cancer for each gene in older women. The analysis included data from 26,707 women older than 65 from population-based studies (51.5% with breast cancer and 48.5% unaffected) who were tested for PVs in germline predisposition genes. The frequency of PVs in predisposition genes was 3.18% for women with breast cancer and 1.48% for unaffected older women. PVs in BRCA1, BRCA2, and PALB2 were identified in 3.42% of women diagnosed with ERnegative breast cancer, 1.0% of women with ERpositive breast cancer, and 3.01% of women with triple-negative breast cancer. Among women with no first-degree relatives with breast cancer, frequencies of PVs were lower. There were increased risks (OR, 2.9-4.0) for breast cancer associated with PVs in CHEK2, PALB2, BRCA2, and BRCA1. For those with PVs in BRCA1, BRCA2, and PALB2, remaining lifetime risks for breast cancer were 15% or greater.
