Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Understanding pathways for genetic testing and counselling for women with ovarian cancer in New South Wales (145499)

Mya Acosta 1 , Melissa Merritt 1 , Anna DeFazio AM 1 2 3 4 , Nicola Meagher 5 , Natalie Taylor 6
  1. The Daffodil Centre, University of Sydney and Cancer Council NSW, Sydney, NSW, Australia
  2. The Westmead Institute for Medical Research, Westmead, NSW, Australia
  3. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  4. The Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia
  5. Medicines Intelligence Research Program School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
  6. Implementation to Impact (i2i), School of Population Health, University of New South Wales, Sydney, NSW, Australia

Background: Universal germline and tumour somatic testing are now standard of care for women with high-grade non-mucinous epithelial ovarian cancer to identify hereditary cancer risk and eligibility for poly (ADP-ribose) polymerase inhibitor treatment. However, implementation of testing and genetic counselling pathways varies across health services, with limited understanding of how these pathways operate in routine clinical practice.

Aims: To map germline and tumour somatic testing and genetic counselling pathways for women with ovarian cancer across New South Wales (NSW) and identify variation in service delivery that may influence implementation of molecular testing in routine care.

Methods: A qualitative descriptive study was undertaken using semi-structured interviews with healthcare professionals involved in referrals for ovarian cancer testing and counselling across metropolitan and regional NSW. A basic process map was used as a visual prompt to support description and refinement of local pathways. Purposive sampling captured diversity in roles and service settings. Interviews were transcribed verbatim and analysed using process mapping to identify pathway steps, decision points, actors, handovers, information flows and bottlenecks.

Results: Nineteen clinicians, including gynaecological oncologists, medical oncologists, genetic counsellors and pathologists, were interviewed. Preliminary findings identified variation in genetics service capacity and integration across NSW.  Regional services described more limited genetics capacity, with sole-clinician models and high workloads influencing how counselling was delivered and limiting capacity for follow-up. Genetics services in metropolitan services was more variable, ranging from closely integrated services to pathways reliant on external referral.

Conclusions: Preliminary findings suggest that variation in genetics service capacity may contribute to inequities in timely access to genetic counselling and follow-up across NSW. Process mapping can identify where additional resourcing and strengthened referral pathways may support more equitable and consistent care for women with ovarian cancer.