‘In the Family’: Experiences of General Practitioners in Wales on the Management of Individuals at Risk of Familial Cancer

Abstract

A cancer genetics service for Wales was established in 1998. This study aimed to obtain baseline information about how often general practitioners (GPs) see patients with cancer genetic concerns, frequency of referral for specialist genetic assessment and knowledge of familial cancer risk. A questionnaire was sent to all GPs in two Local Health Groups in Wales. To determine GPs' management of individuals seeking advice regarding a family history of cancer, five hypothetical cancer history scenarios were presented, including breast, bowel and ovarian cancer. There was substantial variation in the number of patients seeking advice regarding a cancer family history, and a range in the proportion referred onwards for specialist genetic assessment. GPs are aware of the contribution that age of cancer diagnosis and number of affected relatives can have in the genetic risk assessment of an unaffected relative. However, there is uncertainty when a family history corresponds to moderate risk.