Pilot Health Care Provider Education Program for BRCA1 / 2 Genetic Testing, Counseling, and Management in Nigeria

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PURPOSE Breast cancer (BC) is a significant health challenge in Nigeria, exacerbated by early onset, advanced-stage diagnosis, and high prevalence of triple-negative tumors. Access to genetic testing and counseling is scarce, with minimal capacity for hereditary cancer services. Despite these barriers, there is strong interest in expanding care to include genetic testing and improve understanding of familial risk. The purpose of this study was to develop and assess the effectiveness of a BC genetics education program for Nigerian health care providers (HCPs). METHODS A multidisciplinary international team developed a four-module hybrid education program combining asynchronous online learning and an in-person didactic session. Invitations were circulated to HCPs in tertiary hospitals across Nigeria. Knowledge improvement was assessed using standardized pre- and postmodule tests. RESULTS Thirty-one physicians and nurses participated. All online modules had significant knowledge improvement, with the largest score increases in BRCA1 / 2 genetic counseling (mean change, 1.9 [95% CI, 1.3 to 2.5]; P < .001) and BRCA1 / 2 clinical management (mean change, 1.6 [95% CI, 1.2 to 2.1]; P < .001). The subsequent in-person workshop had additional, albeit smaller, module increases. Aggregated analysis showed a 23.0% increase in knowledge after the online training ( P < .001), with a further 10.1% gain after the in-person workshop ( P = .007). Overall knowledge improved from 45.0% at baseline to 87.0% post-training, representing a 43.0% absolute gain ( P < .001). CONCLUSION This hybrid training program significantly improved provider knowledge of hereditary BC genetics in Nigeria and offers a scalable, culturally tailored model for expanding BC genetic services in low-resource settings. While promising, the modest sample size and limited follow-up warrant further evaluation and broader rollout to confirm long-term effectiveness.

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