P-237 Clinical doctors’ attitudes towards colorectal cancer genetic testing: A national multi-center cross-sectional study

Abstract

Colorectal cancer (CRC) is the fifth leading cause in China for cancer-related deaths. CRC per se is a genetic disease, and personalized risk prediction, prevention, and treatment can be based on the results of genetic testing. Patients undergoing gene testing mostly depend on the clinical doctor's attitude towards genetic testing. Therefore, there is an urgent need to understand clinical doctors’ attitudes towards CRC genetic testing. A national, multi-center, cross-sectional study was performed from March to November 2020. All doctors from 27 centers were enrolled by a two-stage, stratified, random sampling procedure. The self-made, semi-structured questionnaire was used to collect the doctors’ recognition of CRC patients for genetic testing, the recommended situation and location of genetic testing, and the recommended items of genetic testing. Descriptive analysis was used to describe the above questions. A total of 247 clinical doctors were enrolled in the study, with an average age of 37.4±7.26 years old. Most doctors (93.5%) believed that genetic testing was necessary for CRC, and recommended it to 62.5% of CRC patients. Unaffordable costs (20.0%) and the difficulty of obtaining test samples (18.6%) were the main barriers for doctors to recommend genetic testing. About 33.2% of the doctors recommended that patients be tested in a hospital, 20.6% recommended an out-of-hospital test, 46.2% recommended either of them. The main reasons for doctors to recommend out-of-hospital testing were that more genes could be detected out of hospital (53.4%) and there was no testing platform in the hospital (45.5%). The tests recommended by doctors were RAS (96.9%), BRAF (93.4%), MSI (90.3%) and MMR (81.6%). This is the first and largest multi-center study to understand the clinical doctors’ attitudes towards colorectal cancer genetic testing. Chinese clinical doctors had a high degree of recognition for CRC genetic testing. There is a need to improve the level of gene testing in hospitals and reduce the cost of genetic testing.