Breast Cancer Genetics in Primary Care Which GPs Most Accurately Categorise Patients at Low Risk?

Abstract

Objective: It is already known that GPs readily identify a role for themselves in breast cancer genetics services, but tend to overestimate risk and admit to a lack of confidence. This study aimed to explore associations with accurate risk categorisation by GPs.Method: A postal survey of all GPs in Nottinghamshire (UK) tested the ability of a GP to correctly categorise a family history of breast cancer and assessed GPs confidence in breast cancer genetic risk categorisation by comparing the process with explaining the risk of taking combined oral contraception, and asked about GPs' attitudes to different models for assessing risk in primary care.Results: The response rate was 61.6% (n=391). Less than 24% of GPs indicated confidence in dealing with familial cancer scenarios. A total of 89.5% of GPs erroneously categorised a low-risk breast cancer family history as moderate or high risk. Accurate genetic risk categorisation for breast cancer was independently associated with the GP regarding counselling in primary care as useful (p<0.01), the GP not regarding direct referral to hospital as useful (p=0.02) and the GP regarding genetic teaching received whilst a principal as adequate (p=0.04). There was no association with self-reported confidence.Conclusions: There was no relationship between accuracy of and self-reported confidence in genetic risk categorisation. Accurate categorisation was associated with regarding counselling in primary care as useful, and with adequate genetic teaching as a principal.