Table 2.

Other emerging genetic counseling indications

Clinical Indication	Factor(s) necessitating change	GC role/HCP role	GC Method	GC Service delivery
Abnormal MSI/IHC results	Population screening efforts Prognostic information/treatment decisions	Ordering MD: surgeon/med oncologist; GC referred only abnormal results and/or suggestive family history	Similar to abnormal prenatal screening results with initial counseling by MD/staff followed by extensive post-test counseling/follow-up by GC	In person or phone (alternate media strategies for pre-test counseling)
Post-test BRCA and Lynch syndrome testing	Patient awareness and advocacy; Direct to physician marketing of genetic based tests	GC establishing collaborative approach for triaging difficult cases	Extensive post-test counseling largely dependent on test result and interpretation (psychologist/social work consultation as needed)	In person