J.L. St. Sauver

Incidence and Factors Associated with Synchronous Ovarian and Endometrial Cancer: A Population-Based Case-Control Study

OBJECTIVE To estimate the incidence of synchronous endometrial cancer (EC) and ovarian cancer (OC) in the female population, among all women with EC, and in women under 50 years of age with EC, and to identify factors associated with synchronous EC/OC. METHODS All cases of synchronous EC/OC and EC diagnosed in women residing in Olmsted County, Minnesota between 1/1/1945 and 12/31/2008 were identified. Incidence was estimated using the population denominator from decennial census data, corrected for hysterectomy prevalence. A case-control study using 15 identified cases (EC/OC) and 45 controls (EC alone) was performed. RESULTS The incidence of synchronous EC/OC and EC (age-adjusted to the 2000 US female total and corrected for hysterectomy prevalence) in 1945-2008 was 0.88 and 30.3 per 100,000 person-years, respectively. Among women under 50 years of age, the corrected incidence of EC/OC and EC was 0.51 and 5.1 per 100,000 person-years, respectively. Among all women with EC, 3.1% had a synchronous OC compared to 9.4% of women under 50 years of age with EC. Patients with synchronous EC/OC were more likely than those with EC alone to present with a pelvic mass (57.1% vs. 8.9%, p<0.001). Patients with EC alone were more likely to have used oral contraceptive pills (OCPs) than synchronous EC/OC cases (22.7% vs 0%; Odds ratio, 0.10; 95% CI, <0.01-0.87). CONCLUSION Although the incidence of synchronous EC/OC in the general population is lower than previously reported, nearly 1 in 10 women diagnosed with EC under 50 years of age will have a synchronous OC.

Electronic Medical Record‐Integrated Pharmacogenomics and Related Clinical Decision Support Concepts

Advances in pharmacogenomics (PGx) have the potential to transform healthcare by allowing precision medicine to become a reality. However, PGx knowledge is new, complex, and evolving, and relying on the cognition of clinicians alone is insufficient for clinical implementation. Integrating clinical decision support (CDS) tools in the electronic health record (EHR) is critical for translating PGx into clinical practice. Herein, we review current strategies to implement PGx using EHR‐CDS functionalities.

Are patients willing to incur out-of-pocket costs for pharmacogenomic testing?

Suzette J. Bielinski, PhD, MEd1, Jennifer L. St. Sauver, PhD1,2, Janet E. Olson, PhD1, Mark L. Wieland, MD3, Carolyn R. Vitek, MS4, Elizabeth J. Bell, PhD1, Michaela E. McGree, BS2,5, Debra J. Jacobson, MS2,5, Jennifer B. McCormick, PhD6, Paul Y. Takahashi, MD3, John L. Black, MD7, Pedro J. Caraballo, MD8, Richard R. Sharp, PhD6,9, Timothy J. Beebe, PhD2,9, Richard M. Weinshilboum, MD10, Liewei Wang, MD, PhD10, and Véronique L. Roger, MD, MPH1,2,11 1Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA