We aimed to understand the decision-making process related to the willingness to undergo BRCA1/2 genetic testing, risk-reducing salpingo-oophorectomy (RRSO), or risk-reducing mastectomy (RRM) among the general public, cancer patients, and healthcare professionals in South Korea. In total, 3444 individuals (1496 from the general public, 1500 cancer patients, 108 clinicians, and 340 researchers) completed a survey addressing genetic testing and related risk management options in a hypothetical scenario. Differences in intent and associated factors for undergoing the above procedures or sharing test results were analyzed. Overall, 67% of participants were willing to undergo BRCA1/2 testing, with proportions of the general public (58%), cancer patients (70%), clinicians (88%), and researchers (90%). The willingness to undergo RRSO was highest among clinicians (58%), followed by among patients (38%), the general public (33%), and researchers (32%) (p < 0.001). Gender, age, education level, and household income were associated with willingness to undergo genetic testing, RRM, and RRSO (p < 0.05). The intent for undergo genetic testing, RRM, and RRSO were affected by many factors. Finally, 69% of the general public intended to share information with family, while this percentage was 92%, 91%, and 94% for patients, clinicians, and researchers, respectively (p < 0.05). These results highlight the requirement for developing targeted educational materials and counseling strategies for facilitating informed decision making.

Purpose The genetic attribution for pancreatic ductal adenocarcinoma (PDAC) has been reported as 5%-10%. However, the incidence of germline pathogenic variants (PVs) in Korean PDAC patients has not been thoroughly investigated. Therefore, we studied to identify the risk factors and prevalence of PV for future treatment strategies in PDAC.Materials and Methods Total of 300 (155 male) patients with a median age of 65 years (range, 33 to 90 years) were enrolled in National Cancer Center in Korea. Cancer predisposition genes, clinicopathologic characteristics, and family history of cancer were analyzed.Results PVs were detected in 20 patients (6.7%, median age 65) in ATM (n=7, 31.8%), BRCA1 (n=3, 13.6%), BRCA2 (n=3), and RAD51D (n=3). Each one patient showed TP53, PALB2, PMS2, RAD50, MSH3, and SPINK1 PV. Among them, two likely PVs were in ATM and RAD51D, respectively. Family history of various types of cancer including pancreatic cancer (n=4) were found in 12 patients. Three patients with ATM PVs and a patient with three germline PVs (BRCA2, MSH3, and RAD51D) had first-degree relatives with pancreatic cancer. Familial pancreatic cancer history and PVs detection had a significant association (4/20, 20% vs. 16/264, 5.7%; p=0.035).Conclusion Our study demonstrated that germline PVs in ATM, BRCA1, BRCA2, and RAD51D are most frequent in Korean PDAC patients and it is comparable to those of different ethnic groups. Although this study did not show guidelines for germline predisposition gene testing in patients with PDAC in Korea, it would be emphasized the need for germline testing for all PDAC patients.

Kim B, et al. Yonsei Med J. 2019 Jan;60(1):73-78. https://doi.org/10.3349/ymj.2019.60.1.73

Background: The increased demand for genetic testing and counseling necessitates healthcare professionals (HCPs) to improve their genetic competency through training programs. This systematic review identified HCPs’ learning needs and their perspectives on essential information for families with hereditary cancer. Methods: This review covered studies published from 2013 to 2024 across five databases. Data were analyzed using a content analysis. Results: Thirteen studies involving 332 HCPs were analyzed. Most studies focused on the learning needs of physicians caring for families affected by Hereditary Breast and Ovarian Cancer in North America and Europe. HCPs required training emphasizing practical counseling skills over the basics of genetics. Learning needs varied by profession: physicians needed training in assessing cancer risk and supporting decision-making in risk management; nurses required information on resources and the genetic care system; genetic counselors sought guidance on family communication and planning. Essential information identified for families included risk-reducing strategies, personalized cancer risk assessment, family implications, psychological issues, (cascade) genetic testing, and social concerns. Conclusions: The findings have implications for the development of training programs for HCPs, emphasizing the need for tailored training based on professions. Future research should explore the needs of HCPs caring for families with diverse hereditary cancers and cultural backgrounds.

In order to bridge the gap between the rapid changes in technology and the healthcare environment, and to alleviate the burden on nursing tasks, the need for change management must be recognized. Understanding nurses' perceptions of generative AI is essential for the successful implementation of nursing change management. However, existing studies are mostly exploratory in nature, focusing on the utility and applications of generative AI technology. There is a lack of research on its implications for the nursing environment and nursing management. The purpose of this study is to explore in depth the perceptions of nurses at cancer specialty hospitals regarding the application of generative AI, as well as the environmental and contextual factors involved. This study conducted in-depth interviews with nurses at A Hospital, the first cancer specialty hospital in South Korea, from July to August 2024. The questionnaire was developed based on clinical nursing practice guidelines, and participants were selected considering the various characteristics and situations of nursing tasks. First, nurses at cancer specialty hospitals recognized change management factors in the areas of 'basic nursing,' 'therapeutic intervention,' 'nursing during examinations,' 'infection control,' and 'nursing administration.' Second, limitations of change management, such as 'decline in nursing proactivity,' 'difficulties in building rapport with patients,' 'difficulties in providing personalized nursing care,' 'patient information breach' and 'unclear accountability,' were identified. Third, preparation strategies for change management, such as 'nurse competency improvement,' 'legal protection,' 'establishing standardized processes,' and 'awareness improvement,' were identified. Based on the research findings, academic and practical implications for the application of generative AI in nursing and strategies to enhance nurses' readiness for its implementation are presented.

Ji Hyung Nam, Myung Koh, Hyoun Woo Kang, Kum Hei Ryu, Dong Seok Lee, Su Hwan Kim, Dong Kee Jang, Ji Bong Jeong, Ji Won Kim, Kook Lae Lee, Dong Jun Oh, Yun Jeong Lim, Seong-Joon Koh, Jong Pil Im, and Joo Sung Kim. Gut and Liver 2022;16:269-76. https://doi.org/10.5009/gnl210417