Challenges and opportunities facing cancer genetic counselors as implementers of rapidly evolving genomic evidence

Authors

• S Arlen

Abstract

Cancer genetic counselors (CGCs) encounter a range of professional challenges and opportunities introduced by novel sequencing technologies and rapidly changing guidelines. To understand how CGCs adapt their service delivery in this landscape, we conducted semi-structured interviews with 24 CGCs, focusing on their institutional culture and climate, the type of institution they work in, their perceived scope of practice relative to that of other health professionals, and the impact of their educational background on their professional practice. Interviews were recorded, transcribed, and analyzed using an iterative, abductive approach to qualitative analysis. Results showed that CGCs are expanding their scope of practice to include the triage of tumor sequencing reports without support or additional formal training. Institutional culture and CGCs’ relationships with colleagues influenced’ their level of professional autonomy and ability to practice at the top of their scope. Patient triage and volume were common challenges necessitating close collaboration with and training of other allied health providers and new workflows, which raised confusion about these different providers’ scopes of practice. Additionally, CGCs emphasized the importance of having easier access to online continuing education and professional development. These findings provide valuable insights into the professional environment and challenges faced by cancer genetic counselors, highlighting areas for potential improvement in training programs and institutional policies to better support their roles and integration within healthcare teams.

Scientific Focus Area: Social and Behavioral Sciences

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