Abstract
BackgroundOvarian cancer is usually diagnosed at a late stage when outcomes are poor. Personalised ovarian cancer risk prediction, based on genetic and epidemiological information and risk stratified management in adult women could improve outcomes. Examining health care professionals’ (HCP) attitudes to ovarian cancer risk stratified management, willingness to support women, self-efficacy (belief in one’s own ability to successfully complete a task), and knowledge about ovarian cancer will help identify training needs in anticipation of personalised ovarian cancer risk prediction being introduced.MethodsAn anonymous survey was distributed online to HCPs via relevant professional organisations in the UK. Kruskal-Wallis tests and pairwise comparisons were used to compare knowledge and self-efficacy scores between different types of HCPs, and attitudes toward population-based genetic testing and risk stratified management were described. Content analysis was undertaken of free text responses concerning HCPs willingness to discuss risk management options with women.ResultsOne hundred forty-six eligible HCPs completed the survey: oncologists (31%); genetics clinicians (30%); general practitioners (22%); gynaecologists (10%); nurses (4%); and ‘others’. Scores for knowledge of ovarian cancer and genetics, and self-efficacy in conducting a cancer risk consultation were generally high but significantly lower for general practitioners compared to genetics clinicians, oncologists, and gynaecologists. Support for population-based genetic testing was not high (<50%). Attitudes towards ovarian cancer risk stratification were mixed, although the majority of participants indicated a willingness to discuss management options with patients.ConclusionsLarger samples are required to investigate attitudes to population-based genetic testing for ovarian cancer risk and to establish why some HCPs are hesitant to offer testing to all adult female patients. If ovarian cancer risk assessment using genetic testing and non-genetic information including epidemiological information is rolled out on a population basis, training will be needed for HCPs in primary care to enable them to provide appropriate support to women at each stage of the process.
Highlights
Ovarian cancer is usually diagnosed at a late stage when outcomes are poor
Clinical genetic testing for BRCA1/2 gene mutations is currently available as a service on the National Health Service (NHS) in the UK to individuals with a 10% or greater chance of carrying a BRCA1/2 mutation [3] including those with high grade non-mucinous ovarian cancer, or those with a strong family history of breast and/or ovarian cancer
10–15% of ovarian cancer cases are believed to be due to a BRCA1/2 mutation [5, 6], ~50% of individuals with a pathogenic BRCA mutation may not report a strong family history of cancer [7, 8]
Summary
Ovarian cancer is usually diagnosed at a late stage when outcomes are poor. Personalised ovarian cancer risk prediction, based on genetic and epidemiological information and risk stratified management in adult women could improve outcomes. Clinical genetic testing for BRCA1/2 gene mutations is currently available as a service on the NHS in the UK to individuals with a 10% or greater chance of carrying a BRCA1/2 mutation [3] including those with high grade non-mucinous ovarian cancer, or those with a strong family history of breast and/or ovarian cancer. 10–15% of ovarian cancer cases are believed to be due to a BRCA1/2 mutation [5, 6], ~50% of individuals with a pathogenic BRCA mutation may not report a strong family history of cancer [7, 8] These families may not be referred to clinical genetics even though current guidelines [9] recommend testing in these situations.
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