Identifying Primary Care Physicians Continuing Education Needs by Examining Clinical Practices, Attitudes, and Barriers to Screening Across Multiple Cancers

Lynn, Brenna M.; Hatry, Alexandra; Burnett, Chloe; Kan, Lisa; Olatunbosun, Tunde; Bluman, Bob

doi:10.1007/s13187-017-1240-5

Cited by 16 publications

(18 citation statements)

References 19 publications

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“…There were no participants from our study who indicated they ceased routine cancer screening due to results of IiP, which has been seen in interviews with other elective proactive genetic testing participants. 13 In contrast, 27.3% of surveyed participants with positive results did not accurately recall their results status, with actual test results ranging from low risk (heterozygous MUTYH ) to high risk ( BRCA2 ). This misinterpretation could have large implications for inaccurate cancer risk management.…”

Section: Discussionmentioning

confidence: 95%

“…It can also reduce non-genetics healthcare providers’ reported genetic testing barriers of limited genetics knowledge, uncertainty with hereditary cancer testing criteria, and time limitations. 13 , 14 Previous research identified population genetic testing as an economically feasible way to identify high-risk hereditary cancer syndromes, given that costs for testing are low enough to outweigh the amount of the population that needs to be screened for impact. 15 , 16 Economic feasibility and the opportunity for intervention to reduce morbidity and mortality through increased screening or surgical interventions make hereditary cancer well suited to population screening given previously published principles.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics and experiences of patients from a community-based and consumer-directed hereditary cancer population screening initiative

Greve

Odom

Pudner

et al. 2022

Human Genetics and Genomics Advances

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Summary A clinical hereditary cancer population screening initiative, called Information is Power, began in North Alabama in 2015. After 4 years of the initiative, we were interested in exploring (1) the characteristics and motivations for patients who self-refer to population genetic testing, (2) how patients make decisions on testing, (3) what patients do with results, and (4) patient perceptions of benefits and limitations after undergoing population genetic testing. Patients who consented to research recontact at time of test ordering were sent an electronic survey with the option for a follow-up phone interview. Among the 2,918 eligible patients, 239 responded to the survey and 19 completed an interview. Survey and interview participants were highly educated information seekers motivated by learning more about their health. Those who were previously interested in hereditary cancer testing reported barriers were cost and insurance coverage, access to testing, and uncertainty how results could impact their health. Many participants (77%) communicated with family and friends about their decision to test and communicated about test results. Fewer participants (23%) discussed the decision to test with their healthcare providers; however, 58% of participants discussed their test results with a healthcare provider. Most people (96%) with negative results accurately recalled their results. In contrast, three out of 11 positive results for heterozygous MUTYH , PALB2 , and BRCA2 reported receiving negative results. This study contributes to knowledge on population genetic testing and may guide other population genetic testing programs as they develop enrollment materials and educational materials and consider downstream needs of population genetic testing participants.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Characteristics and experiences of patients from a community-based and consumer-directed hereditary cancer population screening initiative

Greve

Odom

Pudner

et al. 2022

Human Genetics and Genomics Advances

View full text Add to dashboard Cite

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“…We highlight this because supplemental screening is recommended for women at high breast cancer risk, 15,16,21,22,44,45 and dense breasts alone do not indicate high breast cancer risk 46 . The most frequently occurring response of additional screening likely reflects physicians’ preferences for more aggressive cancer screening, especially when faced with multiple guidelines 47‐49 . Whereas this recommendation is inconsistent with supplemental screening guidelines, it is consistent across physicians regardless of specialty or gender.…”

Section: Discussionmentioning

confidence: 99%

“…46 The most frequently occurring response of additional screening likely reflects physicians' preferences for more aggressive cancer screening, especially when faced with multiple guidelines. [47][48][49] Whereas this recommendation is inconsistent with supplemental screening guidelines, it is consistent across physicians regardless of specialty or gender. Physicians' clinical judgment may favor more aggressive screening; however, the potential for overdiagnosis and other negative outcomes associated with overscreening must be considered.…”

Section: Discussionmentioning

confidence: 99%

Physicians' perceptions of breast density notification laws and appropriate patient follow‐up

2021

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Approximately 40% of women in the United States have dense breasts and associated increased breast cancer risk. [1][2][3][4][5][6] To increase risk women's awareness, breast density notification laws have been adopted in more than half of the United States, 7,8 and a similar federal law was recently adopted. 9,10 These laws are adopted without consistent follow-up guidelines for women who receive notifications, leading to inconsistent physician practices. Since most (55.9%) referrals for supplemental breast screening for dense breasts were from the physician who referred for mammogram, 11 understanding physicians' knowledge and practices relevant to supplemental screening guidelines is warranted.Inconsistent follow-up practices are most problematic for women with dense breasts who are at average (<15% lifetime) breast cancer risk. 12 Citing a lack of evidence, most national health organizations

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“…The results of that study suggested the need to improve awareness and adherence to screening guidelines and recommended practices. 8 …”

Section: Introductionmentioning

confidence: 99%

Physicians’ characteristics and practices associated with the provision of cancer screening advice to their patients: the Spanish SUN cohort study

et al. 2022

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ObjectivesTo evaluate the association between cancer screening counselling provided by medical doctors to their patients and each doctor’s own anthropometrics, lifestyle, cancer screening practices, and personal and family history of cancer.DesignProspective cohort study.SettingSubstudy including physicians participating in a Spanish cohort study with open enrolment.ParticipantsAmong 22 800 participants in the cohort as of May 2018, there were 2371 physicians who had replied to the cohort baseline questionnaire, had an email account and were younger than 65 years (retirement age in Spain). From this subsample, 890 replied to an online questionnaire focused on their clinical practices related to the counselling provided to their patients and to their prescription practices of preventive medications. Their mean age was 51.7 (SD 9.4) years and 48% were women.Outcome measuresFrequency of counselling given to their patients on specific practices of breast, colorectal and prostate cancer screenings.ResultsCounselling on cancer screening to their patients was provided by 65% of physicians in a scenario of colorectal cancer, 59% for prostate cancer and 58% for breast cancer. More frequent cancer screening counselling was associated with the specialties of family medicine (OR=9.4, 95% CI 5.1 to 17.1) and internal medicine (OR=2.9, 95% CI 1.5 to 5.7) as compared with other specialties. Recommending cancer screening was associated with more frequent counselling on smoking cessation (OR=3.7, 95% CI 2.6 to 5.4), having personally attended colorectal cancer screening (OR=2.2, 95% CI 1.1 to 4.7) and prescribing blood pressure medication more often than their colleagues (OR=2.1, 95% CI 1.2 to 3.7).ConclusionsAmong medical doctors, cancer screening counselling was provided to their patients more frequently for doctors with family medicine or internal medicine specialties and for physicians who regularly offered counselling on certain lifestyle behaviours, and those having personally attended colorectal cancer screening. Doctors’ own personal practices and knowledge of healthy lifestyles may help doctors to more frequently provide counselling on cancer screening to their patients.

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Identifying Primary Care Physicians Continuing Education Needs by Examining Clinical Practices, Attitudes, and Barriers to Screening Across Multiple Cancers

Cited by 16 publications

References 19 publications

Characteristics and experiences of patients from a community-based and consumer-directed hereditary cancer population screening initiative

Characteristics and experiences of patients from a community-based and consumer-directed hereditary cancer population screening initiative

Physicians' perceptions of breast density notification laws and appropriate patient follow‐up

Physicians’ characteristics and practices associated with the provision of cancer screening advice to their patients: the Spanish SUN cohort study

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