Workforce Implications of Increased Referrals to Hereditary Cancer Services in Canada: A Scenario-Based Analysis

Author:

Dragojlovic Nick1ORCID,Borle Kennedy1,Kopac Nicola1,Nisselle Amy23ORCID,Nuk Jennifer45,Jevon Mandy4,Friedman Jan M.56,Elliott Alison M.567ORCID,Lynd Larry D.18

Affiliation:

1. Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada

2. Australian Genomics Health Alliance, Parkville, VIC 3052, Australia

3. Murdoch Children’s Research Institute, Department of Pediatrics, The University of Melbourne, Parkville, VIC 3052, Australia

4. Hereditary Cancer Program, BC Cancer, Vancouver, BC V5Z 1J2, Canada

5. Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H 3N1, Canada

6. BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada

7. Women’s Health Research Institute, Vancouver, BC V6H 3N1, Canada

8. Centre for Health Evaluation & Outcome Sciences, Providence Health, Vancouver, BC V6Z IY6, Canada

Abstract

Over the last decade, utilization of clinical genetics services has grown rapidly, putting increasing pressure on the workforce available to deliver genetic healthcare. To highlight the policy challenges facing Canadian health systems, a needs-based workforce requirements model was developed to determine the number of Canadian patients in 2030 for whom an assessment of hereditary cancer risk would be indicated according to current standards and the numbers of genetic counsellors, clinical geneticists and other physicians with expertise in genetics needed to provide care under a diverse set of scenarios. Our model projects that by 2030, a total of 90 specialist physicians and 326 genetic counsellors (1.7-fold and 1.6-fold increases from 2020, respectively) will be required to provide Canadians with indicated hereditary cancer services if current growth trends and care models remain unchanged. However, if the expansion in eligibility for hereditary cancer assessment accelerates, the need for healthcare providers with expertise in genetics would increase dramatically unless alternative care models are widely adopted. Increasing capacity through service delivery innovation, as well as mainstreaming of cancer genetics care, will be critical to Canadian health systems’ ability to meet this challenge.

Funder

Canadian Institutes of Health Research

Genome BC

Genome Quebec

Provincial Health Services Authority

BC Children’s Hospital Foundation

BC Women’s Hospital Foundation

Publisher

MDPI AG

Reference46 articles.

1. National Cancer Institute (2023, July 06). The Genetics of Cancer, Available online: https://www.cancer.gov/about-cancer/causes-prevention/genetics.

2. The Role of Genetic Testing in Patients With Breast Cancer: A Review;Valencia;JAMA Surg.,2017

3. Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors;Trepanier;J. Genet. Couns.,2004

4. Cancer Care Ontario (2018). Recommendation Report for Ontario’s Clinical Genetic Services, Cancer Care Ontario.

5. Utilization and Uptake of Clinical Genetics Services in High-Income Countries: A Scoping Review;Dragojlovic;Health Policy,2021

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