Download Endometrial Cancer Panel

[DATE]
Patient: [PATIENT_FIRST_NAME] [PATIENT_LAST_NAME]
Insurance Company: [INSURANCE_COMPANY_NAME]
Subscriber Name: [POLICY_HOLDER_NAME]
Policy #: [POLICY_NUMBER]
Dear Claims Specialist,
I am writing this letter on behalf of my patient, [PATIENT_FIRST_NAME]
[PATIENT_LAST_NAME], to request coverage for the OncoGeneDx Endometrial Cancer panel,
a genetic test offered through GeneDx, a high complexity CLIA certified laboratory located in
Gaithersburg, Maryland.
Personal and Family History:
[PATIENT_FIRST_NAME] is a [PATIENT_AGE] year-old [PATIENT_GENDER] suspected to
have a hereditary predisposition to cancer. [MR./MS.] [PATIENT_LAST_NAME] was diagnosed
with XX cancer at age XX years. [HIS_HER] family history is remarkable for (discuss family
history). [MR./MS.] [PATIENT_LAST_NAME]’s (personal and/or family) history is suggestive of a
hereditary cancer syndrome. However, the only way to thoroughly assess this patient’s future cancer
risks is to perform genetic testing. The results of this genetic test will have a direct impact on
this patient’s treatment and management.
Test Information and Impact of Results on Medical Management:
As you are aware, multiple genes and cancer syndromes are associated with hereditary endometrial
cancer. The OncoGeneDx Endometrial Cancer panel includes analysis of highly penetrant genes
affecting endometrial cancer risk. Panel testing utilizes next generation sequencing technology,
which allows for analysis of multiple genes simultaneously. This is far more cost effective and timely
than stepwise genetic testing (for example, ordering testing of one or two genes followed by
additional genetic tests, if negative).
An additional benefit of the OncoGeneDx Endometrial Cancer panel is the ability to test for
multiple hereditary cancer syndromes at once. Many hereditary endometrial cancer pedigrees display
significant phenotypic overlap with those of other hereditary cancer syndromes. For example,
multiple cases of endometrial cancer and colorectal polyps may be present in a family with Lynch
syndrome (associated with mutations in MLH1, MSH2, MSH6, PMS2 and EPCAM) or with
Cowden syndrome (associated with mutations in PTEN). A hereditary cancer syndrome diagnosis
cannot always be established based upon the pedigree analysis alone. The OncoGeneDx
Endometrial Cancer panel tests for genes associated with multiple hereditary cancer syndromes that
may present similarly, including Lynch syndrome, Cowden syndrome, Li-Fraumeni syndrome and
hereditary breast/ovarian cancer syndrome (BRCA1 and BRCA2). While each of these syndromes is
associated with a significantly increased risk of endometrial cancer and other cancers, each syndrome
has gene-specific and site-specific cancer risks for which National Comprehensive Cancer Network
(NCCN) management recommendations differ1,2. These may include increased cancer surveillance
and options for prophylactic surgeries and chemoprevention. Thus, it is essential that an
accurate diagnosis is established for this patient in order to determine [HIS_HER]
appropriate medical management.
Conclusion:
Knowledge of this patient's genetic information is important for me to more accurately assess
[HIS_HER] cancer risks and will guide my recommendations for [HIS_HER] care. I have chosen to
send the patient’s test to GeneDx because this laboratory has highly sensitive, rapid and costeffective genetic testing for hereditary breast and/or ovarian cancer, which will provide helpful
medical treatment planning information for my patient.
Thank you for your review and consideration. I hope you will support this request for genetic
testing coverage for [PATIENT_FIRST_NAME] [PATIENT_LAST_NAME]. If you have
questions, or if I can be of further assistance, please do not hesitate to call me at
[PHYSICIAN_PHONE_NUMBER].
Sincerely,
[PHYSICIAN_FIRST_NAME] [PHYSICIAN_LAST_NAME], MD
cc:[PATIENT_FIRST_NAME][PATIENT_LAST_NAME]
1. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Genetic/Familial
High-Risk Assessment: Breast and Ovarian. Version 1.2015. www.nccn.org.
2. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Genetic/Familial
High-Risk Assessment: Colorectal. Version 2.2014. www.nccn.org.