PURPOSE We analyzed the patients served by the University of Washington Adult Genetic Medicine Clinic (UWAGMC) over a 42-year period to determine how clinical services have changed and to evaluate the contributing factors. METHODS We conducted a retrospective survey of patients seen by UWAGMC that included patients seen from 1975 to 2016. Variables considered included referral indication, disease status, and clinic visit date. Indications for referral were then binned into clinical categories for descriptive analysis. RESULTS Of 30,780 patient visits during the 39 years for which data were available, 57.3% occurred in the last decade. Referrals for breast/ovarian cancer or colon/endometrial cancer account for 74.8% of cancer referrals since 1998. Huntington disease patients made up 46% of neurological referral indications. Telephone screening implemented in 2013 has reduced the number of referrals for hypermobile Ehlers-Danlos syndrome. CONCLUSION Referral indications increased with clinical testing availability and because of the academic programs of UWAGMC providers. With increased public awareness of heritable conditions, prescreening self-referrals were used to allocate limited resources. These trends demonstrate the need for more geneticists in adult medicine to expand centers of excellence for rare diseases and to serve the increasing numbers of adult patients with genetic conditions.

中文翻译：

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华盛顿大学成人医学遗传学诊所 42 年来的趋势。

目的 我们分析了华盛顿大学成人遗传医学诊所 (UWAGMC) 过去 42 年服务的患者，以确定临床服务的变化情况并评估影响因素。方法 我们对 UWAGMC 就诊的患者进行了一项回顾性调查，其中包括 1975 年至 2016 年就诊的患者。考虑的变量包括转诊适应症、疾病状态和就诊日期。然后将转诊适应症分类为临床类别以进行描述性分析。结果 在 39 年间有数据可用的 30,780 次患者就诊中，57.3% 发生在过去十年中。自 1998 年以来，乳腺癌/卵巢癌或结肠/子宫内膜癌的转诊占癌症转诊的 74.8%。亨廷顿病患者占神经系统转诊适应症的 46%。2013 年实施的电话筛查减少了超移动型 Ehlers-Danlos 综合征的转诊数量。结论 随着临床测试的可用性和 UWAGMC 提供者的学术计划，转诊适应症增加。随着公众对遗传条件的认识提高，预先筛选的自我推荐被用于分配有限的资源。这些趋势表明，需要更多的成人医学遗传学家来扩大罕见病卓越中心，并为越来越多的患有遗传病的成年患者提供服务。随着公众对遗传条件的认识提高，预先筛选的自我推荐被用于分配有限的资源。这些趋势表明，需要更多的成人医学遗传学家来扩大罕见病卓越中心，并为越来越多的患有遗传病的成年患者提供服务。随着公众对遗传条件的认识提高，预先筛选的自我推荐被用于分配有限的资源。这些趋势表明，需要更多的成人医学遗传学家来扩大罕见病卓越中心，并为越来越多的患有遗传病的成年患者提供服务。