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

Background:Primary health care providers are expected to bedirectly involved in the genetic testing for cancer susceptibility. This studyassessed physicians' knowledge, attitude and perception of their role towardstesting for hereditary breast–ovarian cancer.Design:A mail-in survey was sent to all general practitioners,internists, obstetrician-gynecologists and oncologists in private practice inGeneva county, Switzerland. Questions included socio-demographic variables,knowledge about hereditary breast–ovarian cancer, attitude towardstesting and assessment of their role in the pre- and post-test procedure.Results:Two hundred fifty-nine (65%) of four hundredquestionnaires were returned of which two hundred forty-three (61%)were analysed. Response rates were similar between specialties; women answeredmore frequently. The majority of the respondents (87%) approved ofgenetic susceptibility testing. The most common objection to testing was theabsence of approved strategies for the prevention and detection of earlybreast cancer. Most physicians felt they had an active part to play in thepre-test procedure, the disclosure of results, and especially the consultants'long-term care and support (99%). Physicians correctly answered a third(32%) of the knowledge questions. The abstention rate for individualitems ranged from 13% to 60%. Scores varied by specialty.Oncologists were more knowledgeable than gynecologists, internists and generalpractitioners.Conclusions:The majority of the primary care physicians in thisstudy have a favourable attitude and are ready to play a prominent role ingenetic counseling and testing for breast–ovarian cancer predisposition.Defective knowledge scores, however, underline the need for targetededucational programs.