Primary care physicians' knowledge and attitudes towards genetic testing for breast-ovarian cancer predisposition

Escher, Monica; Sappino, André‐Pascal

doi:10.1023/a:1008319114278

Cited by 88 publications

(88 citation statements)

References 24 publications

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“…This association between knowledge scores and gender was not found in other studies on genetics knowledge among physicians in the Netherlands (Baars MJH et al, unpublished data, 2005). 4,6 In general, no differences were found between students from different medical schools, except that students from one medical school (A) scored significantly lower, compared to those from two of the other six medical schools (E and G).…”

Section: Genetic Knowledge Among Medical Studentsmentioning

confidence: 87%

“…[1][2][3][4]7 However, genetic knowledge and skills are relevant because the recent rapid developments in this field have given rise to increasing patient demands for management of the genetic aspects of their illnesses, requiring doctors to be increasingly more equipped to deal with these demands. 15 This situation could be improved by allocating more time to genetics in the curricula.…”

Section: Genetic Knowledge Among Medical Studentsmentioning

confidence: 99%

“…Several studies have shown that many nongenetic health care providers lack the necessary knowledge and skills to react appropriately to the increasing demands of patients. [1][2][3][4][5][6][7] One possible cause of this reported lack of knowledge and skills is deficiency in the medical curriculum. In the Netherlands, medical undergraduate education takes a minimum of 6 years of theoretical and practical work at one of eight universities.…”

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confidence: 99%

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Deficient knowledge of genetics relevant for daily practice among medical students nearing graduation

Baars

Scherpbier²,

Henneman

et al. 2005

Genetics in Medicine

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Purpose: The objective of this study was to investigate whether the knowledge of genetics relevant for daily practice among medical students nearing graduation in the Netherlands was sufficient to react appropriately to the change of relevance of genetics in medicine. Methods: A computer examination validated in a group of clinical geneticists, medical students nearing graduation, and nonmedical students. The examination consisted of 215 genetic questions classified by the designers into three categories of relevance: "essential" knowledge (requirement: Ͼ 95% correct answers), "desirable" knowledge (requirement: Ͼ 60% correct answers), and "too specialized" knowledge (no requirement). To set an independent standard, the questions were also judged by clinical geneticists and nongenetic health care providers in an Angoff procedure. In total, 291 medical students nearing graduation from seven out of the eight medical schools in the Netherlands participated. Results: As expected, the mean score for "essential" knowledge (71.63%, 95% CI 70.74 -72.52) was higher than for "desirable" knowledge (55.99%, 95% CI 55.08 -56.90); the mean score for "too specialized" knowledge (44.40%, was the lowest. According to passing scores set for "essential" knowledge as defined by the designers, the clinical geneticists, and the nongenetic health care providers, only 0%, 26%, and 3%, respectively, of the participants would have passed. Conclusions: Medical students nearing graduation lack genetic knowledge that is essential for daily practice. Therefore, changes should be made in the medical curricula. Genet Med 2005:7(5):295-301.

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Section: Genetic Knowledge Among Medical Studentsmentioning

confidence: 87%

Section: Genetic Knowledge Among Medical Studentsmentioning

confidence: 99%

mentioning

confidence: 99%

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Deficient knowledge of genetics relevant for daily practice among medical students nearing graduation

Baars

Scherpbier²,

Henneman

et al. 2005

Genetics in Medicine

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“…Low perceived clinical utility, as well as concerns about potential discrimination, have repeatedly been reported as primary barriers to uptake of both traditional genetic testing and newer applications [35][36][37][38][39] . Similarly, we found that uncertain clinical utility was among the top concerns of respondents for themselves and their patients.…”

Section: Discussionmentioning

confidence: 99%

Genomic Risk Profiling: Attitudes and Use in Personal and Clinical Care of Primary Care Physicians Who Offer Risk Profiling

et al. 2011

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BACKGROUND: Genomic risk profiling involves the analysis of genetic variations linked through statistical associations to a range of disease states. There is considerable controversy as to how, and even whether, to incorporate these tests into routine medical care. OBJECTIVE: To assess physician attitudes and uptake of genomic risk profiling among an 'early adopter' practice group. DESIGN: We surveyed members of MDVIP, a national group of primary care physicians (PCPs), currently offering genomic risk profiling as part of their practice. POPULATION: All physicians in the MDVIP network (N =356) RESULTS: We obtained a 44% response rate. One third of respondents had ordered a test for themselves and 42% for a patient. The odds of having ordered personal testing were 10.51-fold higher for those who felt well-informed about genomic risk testing (p < 0.0001). Of those who had not ordered a test for themselves, 60% expressed concerns for patients regarding discrimination by life and longterm/disability insurers, 61% about test cost, and 62% about clinical utility. The odds of ordering testing for their patients was 8.29-fold higher among respondents who had ordered testing for themselves (p < 0.0001). Of those who had ordered testing for patients, concerns about insurance coverage (p = 0.014) and uncertain clinical utility (p = 0.034) were associated with a lower relative frequency of intention to order testing again in the future. CONCLUSIONS: Our findings demonstrate that respondent familiarity was a key predictor of physician ordering behavior and clinical utility was a primary concern for genomic risk profiling. Educational and interpretive support may enhance uptake of genomic risk profiling.

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“…In reality, however, general practitioners (GPs) find this 'gatekeeper' role difficult, both in the UK (Fry et al, 1999;Bankhead et al, 2001;Rose et al, 2001;Walter et al, 2001;Elwyn et al, 2002;Campbell et al, 2003) and elsewhere (Escher and Sappino, 2000). The proportion of referrals to breast cancer family clinics that fall below the required risk threshold has been reported as almost 25% in one large UK-wide survey (Wonderling et al, 2001).…”

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confidence: 99%

Familial breast cancer: management of ‘lower risk’ referrals

et al. 2006

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Up to 40% of referrals from primary care to 'breast cancer family clinics' prove to be of women whose assessed risk falls below the guidelines' threshold for management in secondary or tertiary care, despite recommendations that they should be screened out at primary care level. A randomised trial, involving 87 such women referred to the Tayside Familial Breast Cancer Service compared two ways of communicating risk information, letter or personal interview. Both were found to be acceptable to referred women and to their family doctors, although the former expressed a slight preference for interview. Only four women returned to their family doctors with continuing concerns about breast cancer. Nevertheless, understanding of information provided by either route was unsatisfactory, with apparent confusion about both absolute and relative risks of breast cancer. Substantial minorities appear to believe that they are at no increased risk at all, or even below the population level of risk, while others remain convinced that their personal risk has been underestimated. Family history record forms, completed by the referred women, preferably with the assistance of relatives, are crucial to full assessment of familial risk but one quarter of women referred to the Tayside Familial Breast Cancer Service currently do not complete and return these forms ahead of their clinic appointment. Further collaboration between primary care and the Breast Cancer Family Service is required to improve provision for concerned women whose risks fall below the threshold for special surveillance and to maximise effective use of the family history record form.

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Primary care physicians' knowledge and attitudes towards genetic testing for breast-ovarian cancer predisposition

Abstract: The majority of the primary care physicians in this study have a favourable attitude and are ready to play a prominent role in genetic counseling and testing for breast ovarian cancer predisposition. Defective knowledge scores, however, underline the need for targeted educational programs.

Cited by 88 publications

References 24 publications

Deficient knowledge of genetics relevant for daily practice among medical students nearing graduation

Deficient knowledge of genetics relevant for daily practice among medical students nearing graduation

Genomic Risk Profiling: Attitudes and Use in Personal and Clinical Care of Primary Care Physicians Who Offer Risk Profiling

Familial breast cancer: management of ‘lower risk’ referrals

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