Georgia Breast Cancer Genomic Health Education, Surveillance and Policy (ESP)

Program Description

In 2011 the Georgia Department of Public Health was awarded funding through a three-year CDC Division of Cancer Prevention and Control (DCPC) Cooperative Agreement entitled Georgia Breast Cancer Genomics ESP (Education, Surveillance and Policy). The Department has partnered with the Georgia Center for Oncology Research and Education, Inc. (Georgia CORE) to implement the program in concert with Emory University, the Morehouse School of Medicine and Georgia State University.

The overarching goal of the initiative is to promote the use of evidence-based guidelines to improve the identification of young women at genetic risk for breast cancer and ovarian cancer, with the ultimate goal of reducing the cancer burden in this population and in disparate sub-populations. The three main areas of focus, each with specific and definable objectives, include education, surveillance and policy. Existing US Preventive Services Task Force (USPSTF) and National Comprehensive Cancer Network (NCCN) guidelines will provide the foundation to maximize the understanding and utilization of appropriate genetic assessment within four targeted groups: clinicians, public health practitioners, payers/policy makers and young women at risk.

This program addresses the following “Healthy People 2020” goals:

Educational Objective: Increased knowledge and awareness of methods and benefits of identifying women at risk for hereditary breast/ovarian cancer among clinicians, public health practitioners, insurers and young women

• Identification of knowledge gaps within the target groups
• Education to facilitate integration of genetic risk screening protocols into existing Breast and Cervical Cancer Prevention Programs (BCCP)
• Creation of a multi-faceted educational curriculum, incorporating novel techniques
• Establishment of partnerships with organizations dedicated to furthering the field of breast cancer genomics, and sharing resources to promote educational programming statewide

Surveillance Objective: Assess the utilization of and barriers to cancer genetic services

• Development of a Breast Cancer Genetics Services Network of genetic counselors throughout the state to ascertain baseline and post-implementation data
• Implementation of the Breast/Ovarian Cancer Genetics Referral Screening Tool(B-RST) to improve the identification of women at high risk for appropriate referral to genetic services
• Assessment of insurance coverage for genetic services among major carriers pre- and post-implementation

Policy Objective: Expand coverage for cancer genetic services for high risk women

• Provide cost-benefit analysis to insurers for cancer genetic risk assessment
• Promote the inclusion of cancer genetic services as covered services through dialogue with legislative representatives
• Promote coverage of cancer genetic services through partnerships with existing advocacy groups
• Explore alternative payment modalities for uninsured or underinsured individuals to pursue cancer genetic risk assessment

Outcome Measures

• Number of educational programs provided and measures of knowledge change among providers, insurers and individuals
• Number of high risk women identified through B-RST as eligible for cancer genetic services and the number receiving these services stratified by insurance coverage and demographics
• Number of insurance carriers providing coverage for clinical cancer genetic services