TY - JOUR
T1 - Challenges in diagnosis and biomarker testing for RET-altered lung and thyroid cancer care
T2 - an international mixed-method study
AU - Lazure, Patrice
AU - Sireci, Anthony
AU - Subbiah, Vivek
AU - Murray, Suzanne
AU - Grohé, Christian
AU - Sherman, Steven I
AU - Kelly, Elizabeth
AU - Bubach, Patrick
AU - Péloquin, Sophie
N1 - Funding Information:
This study was financially supported with educational research funds from Eli Lilly and Company.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Background: The introduction of new targeted therapies for RET-altered lung and thyroid cancers (LC/TC) has impacted pathologists’ practice by making genomic testing more relevant. Variations in health systems and treatment access result in distinct clinical challenges and barriers. This study aimed to assess practice gaps and challenges experienced by pathologists involved in the diagnosis of RET-altered LC/TC, including biomarker testing, to inform educational solutions. Methods: Pathologists in Germany, Japan, the UK, and US participated in this ethics-approved mixed-methods study, which included interviews and surveys (data collected January-March 2020). Qualitative data was thematically analysed, quantitative data was analysed with chi-square and Kruskal–Wallis H-tests, and both were triangulated. Results: A total of 107 pathologists took part in this study. Knowledge gaps were reported regarding genomic testing for LC/TC in Japan (79/60%), the UK (73/66%), and the US (53/30%). Skill gaps were reported when selecting genomic biomarker tests to diagnose TC in Japan (79%), the UK (73%) and US (57%) and when performing specific biomarker tests, especially in Japan (82% for RET) and in the UK (75% for RET). Japanese participants (80%) reported uncertainty about what information to share with the multidisciplinary team to ensure optimal patient-centered care. At the time of data collection, pathologists in Japan faced access barriers to using RET biomarker tests: only 28% agreed that there are relevant RET genomic biomarker tests available in Japan, versus 67% to 90% in other countries. Conclusions: This study identified areas where pathologists need additional continuing professional development opportunities to enhance their competencies and better support delivery of care to patients with RET-altered lung or thyroid tumours. Addressing identified gaps and improving competencies of pathologists in this field should be emphasised in continuing medical education curricula and through quality improvement initiatives. Strategies deployed on an institutional and health system level should aim to improve interprofessional communication and genetic biomarker testing expertise.
AB - Background: The introduction of new targeted therapies for RET-altered lung and thyroid cancers (LC/TC) has impacted pathologists’ practice by making genomic testing more relevant. Variations in health systems and treatment access result in distinct clinical challenges and barriers. This study aimed to assess practice gaps and challenges experienced by pathologists involved in the diagnosis of RET-altered LC/TC, including biomarker testing, to inform educational solutions. Methods: Pathologists in Germany, Japan, the UK, and US participated in this ethics-approved mixed-methods study, which included interviews and surveys (data collected January-March 2020). Qualitative data was thematically analysed, quantitative data was analysed with chi-square and Kruskal–Wallis H-tests, and both were triangulated. Results: A total of 107 pathologists took part in this study. Knowledge gaps were reported regarding genomic testing for LC/TC in Japan (79/60%), the UK (73/66%), and the US (53/30%). Skill gaps were reported when selecting genomic biomarker tests to diagnose TC in Japan (79%), the UK (73%) and US (57%) and when performing specific biomarker tests, especially in Japan (82% for RET) and in the UK (75% for RET). Japanese participants (80%) reported uncertainty about what information to share with the multidisciplinary team to ensure optimal patient-centered care. At the time of data collection, pathologists in Japan faced access barriers to using RET biomarker tests: only 28% agreed that there are relevant RET genomic biomarker tests available in Japan, versus 67% to 90% in other countries. Conclusions: This study identified areas where pathologists need additional continuing professional development opportunities to enhance their competencies and better support delivery of care to patients with RET-altered lung or thyroid tumours. Addressing identified gaps and improving competencies of pathologists in this field should be emphasised in continuing medical education curricula and through quality improvement initiatives. Strategies deployed on an institutional and health system level should aim to improve interprofessional communication and genetic biomarker testing expertise.
KW - Continuing professional development
KW - Diagnostic techniques and procedures
KW - Genetic biomarker testing
KW - Lung cancers
KW - Medullary thyroid cancer (MTC)
KW - Needs assessment
KW - Pathology
KW - Quality assurance
KW - RET-alteration
KW - Thyroid cancers
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U2 - 10.1186/s12909-023-04396-w
DO - 10.1186/s12909-023-04396-w
M3 - Article
C2 - 37277734
AN - SCOPUS:85160980539
SN - 1472-6920
VL - 23
JO - BMC Medical Education
JF - BMC Medical Education
IS - 1
M1 - 410
ER -