Abstract 1001: Leveraging Electronic Health Records to examine the real-world rates of cancer genetics referrals in a Singapore healthcare cluster

Abstract Identifying patients with hereditary cancer syndromes through genetics referral enhances early detection and reduces healthcare costs. Despite potential benefits, genetics referral rates globally, including Singapore, remain low. This study investigates the real-world rates of genetics referrals in eligible cancer patients at Singapore’s largest healthcare cluster using Electronic Health Records. Referral criteria for genetics referrals were based on international guidelines. The institution’s data repository was queried for eligible patients with relevant diagnosis codes from 2017 to 2021. We assessed genetics clinic attendance among eligible patients to evaluate referral rates. Variations in referral rates over time were analyzed using linear regression and two-tailed t-test. Of the 10080 patients eligible for a genetics referral, 17.1% (1719) were referred to a cancer genetics clinic. Breast, ovarian, colorectal, and endometrial cancers accounted for 42.9%, 33.5%, 11.3%, and 8.6% of referrals, respectively. Other tumor types accounted for 3.7% of referrals. Referral rates for suspected Hereditary Breast and Ovarian Cancer syndrome (HBOC)-related cancers were higher (19.7%) than referrals for suspected Lynch syndrome (12.2%). Among HBOC referrals, women (20.7%) were more likely to be referred than males (7.8%). From 2017 to 2021, the referral rates among eligible patients steadily increased from 11.6% (483/4174) in 2017 to 23.6% (403/1705) in 2021, an increase of 12%, p=0.005. From 2017 to 2021, we found an increase in referral rates for HBOC (12.8% to 28.6 %, p= 0.005) but not for Lynch syndrome-related indications (8% to 12.6%, p=NS). The increase in referral rates for suspected HBOC in women was more significant than in men (p=0.03) This study found lower referral rates for Lynch syndrome than HBOC, and identified a gender discrepancy, with men with HBOC being less likely to be referred. Efforts to increase referral rates should include raising clinician awareness and electronically identifying suspected cases, especially for male breast cancer and Lynch Syndrome. Citation Format: Jonathan Jian Hao Soon, Jianglei Wu, Nur Diana Binte Ishak, See Wei Qiang, Hing Pong Matthew Che, Michael Dorosan, Jeanette Yuen, Andrea Wan Ling Tan, Marcus Eng Hock Ong, Sean Shao Wei Lam, Hwee Lin Wee, Jianbang Chiang, Joanne Ngeow. Leveraging Electronic Health Records to examine the real-world rates of cancer genetics referrals in a Singapore healthcare cluster [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1001.