Barriers to the practice of cancer genetic by primary care providers

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6149 Background: Genetic testing is available for genes associated with cancer risk (BRCA1/2, MLH1/MSH2, etc). Results of testing has implications for risk assessment, cancer screening and prevention options. Often patients first seek counseling from their primary care provider (PCP). We report preliminary data from a study which seeks to understand the needs of PCPs regarding the practice of cancer genetics. Methods: Three major activities comprise this study. 1.In-depth interviews with 30–60 PCPs, serving a culturally and economically diverse group of patients in urban, rural and suburban settings in order to document PCPs' understanding of cancer genetics and barriers to the practice of cancer genetics in primary care settings. 2. A survey will be administered to 1422 PCPs in the above practice settings to provide a generalizable assessment of attitudes towards the practice of cancer genetics. 3. An expert panel, comprised of primary care providers and experts in cancer genetics, will use the data collected from PCPs to formulate standards for PCP knowledge and make recommendations for educational interventions designed to assist physicians in meeting those standards. Results: 18 physician interviews have been performed in individuals from all three sites and all specialties. Medical school graduation ranges from 1963–98. Themes emerging from these interviews suggest: -Lack of training in genetics even for recent graduates -Lack of confidence in interpretation of cancer family history and referral for genetic counseling and testing. Referrals often at the request of the patient -Cancer family history commonly focuses on cancers for which screening can be increased (breast, colon, etc) -PCPs may recommend against counseling and testing due to lack of trust in technology (interpretation of test results) and discrimination. PCPs are concerned about cost of testing and unaware of insurance coverage for testing -PCPs lack understanding of psychosocial issues regarding genetic testing. Conclusions: Preliminary results suggest that PCPs are commonly uninformed regarding options for genetic counseling and testing for cancer risk. No significant financial relationships to disclose.