Abstract
Genetic testing for susceptibility for common cancers is widely available. Thus, doctors have a role in identifying and referring patients who would benefit from a consultation with a specialist in genetics. This study aims to assess doctors’ referral rates, knowledge and attitudes towards cancer genetic testing, broken down by specialty (gastrointestinal, breast/ovarian, other specialties and General Practitioners-GPs). A 4-page questionnaire was mailed out to the GPs of all patients seen in 2012 in the Hereditary Cancer Clinic of St. Vincent’s Hospital Sydney (n = 128) and all the specialists in St. Vincent’s Hospital Sydney that might refer to the HCC (n = 33). 50 questionnaires were returned (31 %). Most doctors had referred a patient for cancer genetic testing (90 %). The average proportion of patients referred was 1 in 68.5 patients with breast/ovarian specialists referring the most, followed by gastrointestinal specialists and GPs. There was suboptimal knowledge of cancer genetic testing amongst doctors. Breast/ovarian specialists were most knowledgeable, followed by gastrointestinal specialists, other specialists and GPs. There were indications of inappropriate referral amongst doctors. Most (77.6 %) doctors were willing to receive further information on cancer genetics. Nearly all (94 %) doctors believe that it is their duty to inform an individual at high risk for hereditary cancer that cancer genetic counselling and testing is available. The majority of doctors have positive attitudes towards cancer genetic testing. Defective knowledge scores, however, indicate that doctors need further training or tools to enable them to refer patients appropriately for cancer genetic testing.
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Acknowledgments
We thank Cassandra Shearer, Robert Kent, Louise Lynagh and Manisha Chauhan for their help in designing and carrying out this survey. We also thank Jason Chen for assistance in statistical analyses.
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Appendices
Appendix 1
Appendix 2: The correct answers to the knowledge questions (Question 6, 8, 9, 10, 12)
Question no. | Question | Correct answer | |
|---|---|---|---|
6 | How important are each of the factors below in your decision making on whether to refer someone for cancer genetic testing? Please rate from 1 (least important) to 5 (most important) by circling the appropriate number. | 1–3 = Not important 4 & 5 = Important | |
Number of family members of patient with cancer | Important | ||
Age of onset of cancer in family member(s) of patient | Important | ||
Presence of a known mutation in a family member of patient | Important | ||
Age of onset of cancer in patient | Important | ||
Patients’ request | Not important | ||
Features of patients’ disease (e.g. triple negative breast cancer or multiple colorectal polyps) | Important | ||
Impact on further treatment | Important | ||
Impact on future surveillance | Important | ||
8 | Please estimate the current cost for the first family member (the proband) to undergo cancer genetic testing? | $1000–1999 | |
9 | Please estimate the current turnaround time for the first family member (the proband) to undergo routine cancer genetic testing? | 4–8 weeks | |
10 | Please estimate the current turnaround time for the first family member (the proband) to undergo urgent cancer genetic testing? | 1–2 weeks | |
12 | Can a person with no cancer and no proven gene mutation in his/her family be referred to a Hereditary Cancer Clinic for cancer genetic testing; if yes, please describe the circumstances under which this might be so | Yes and in the reason section, the respondent indicated that the patient was eligible for Ashkenazi testing or stated ethnicity | |
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Teng, I., Spigelman, A. Attitudes and knowledge of medical practitioners to hereditary cancer clinics and cancer genetic testing. Familial Cancer 13, 311–324 (2014). https://doi.org/10.1007/s10689-013-9695-y
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DOI: https://doi.org/10.1007/s10689-013-9695-y