CDC’s Cancer Genomics Program Logic Model

Screenshot of the logic model for CDC’s Cancer Genomics program. Text description below.

Strategy 1: Surveillance

Short-Term Outcome

Improved data on hereditary cancer burden and utilization of cancer genetics services.

Intermediate Outcome

Utilization of data to inform program planning.

Strategy 2: Public Education and Awareness

Short-Term Outcome

Increased public awareness and knowledge about family history of cancer and the benefits of genetic counseling and testing.

Intermediate Outcome

Increased proportion of individuals report that they are aware of their family history of cancer and that they have discussed it with a medical provider.

Long-Term Outcome

Increased proportion of the general population has had their family health history evaluated for cancer risk.

Strategy 3: Provider Education

Short-Term Outcomes

  • Increased provider engagement with educational materials, more CMEs awarded, and increased attendance at in-person sessions.
  • Increased provider knowledge and self-efficacy to apply professional guidelines and clinical communication, record family health history, use referral tools recommended by the U.S. Preventive Services Task Force (USPSTF), and to refer patients to genetic counseling and testing.

Intermediate Outcomes

  • Increased number of providers using family health history screening and tumor testing to identify individuals at high risk for hereditary cancer.
  • Increased appropriate referrals to genetic counseling and testing for—
    • Individuals who meet high-risk criteria from family health history of cancer(s).
    • Individuals with newly diagnosed colorectal or endometrial cancer and a positive tumor screen.
    • Individuals diagnosed with breast cancer under age 45, colorectal cancer under age 50, or ovarian cancer at any age.
    • Individuals with a first-degree relative that has been diagnosed with a pathogenic variant of BRCA1/2 or a MMR gene.
    • Any other individuals identified through practice guidelines such as National Comprehensive Cancer Network (NCCN), Evaluation of Genomic Applications in Practice and Prevention (EGAPP), and USPSTF not described above.

Long-Term Outcomes

  • Increased proportion of the general population has had their family health history evaluated for cancer risk.
  • Increased appropriate utilization of genetic counseling and testing.
  • Increased proportion of individuals at high risk for a hereditary cancer who are counseled on and utilize risk management strategies.
  • Reduced incidence and mortality of cancers associated with hereditary breast and ovarian cancer (HBOC) and Lynch syndrome.

Strategy 4a: Partnership

Short-Term Outcome

Develop key partnerships to facilitate the collection of data, provide additional capacity for the implementation of activities, and aid in the evaluation of outcomes.

Strategy 4b: Policy/Systems Change through Partnerships

Short-Term Outcomes

  • Policy and systems change to improve access to and utilization of genetic counseling, testing, and risk management for HBOC and Lynch syndrome.
  • Reduced system barriers for the access of family health history screening, tumor testing, and other cancer genetic services.

Intermediate Outcomes

  • Improved referral patterns for cancer genetic services.
  • Increased health systems with universal tumor screening protocols for Lynch syndrome among newly diagnosed cancer patients.

Long-Term Outcomes

  • Increased appropriate utilization of genetic counseling and testing.
  • Increased proportion of individuals at high risk for a hereditary cancer who are counseled on and utilize risk management strategies.
  • Reduced incidence and mortality of cancers associated with HBOC and Lynch syndrome.

Evaluation of Activities Using Both Process and Outcome Measures

Contextual factors: Resources, changing NCCN and USPSTF guidelines, state geography and access to certified genetic counselors, low genetic literacy, cultural beliefs about cancer, and other campaigns addressing hereditary cancers.

Page last reviewed: January 23, 2019