Swiss primary care physicians' knowledge, attitudes and perception towards genetic testing for hereditary breast cancer.

Abstract

The Swiss Institute for Applied Cancer Research's (SIAK) Network for Cancer Predisposition Testing and Counseling was established in 1999. To define its role in the care of individuals with inherited cancer predisposition, attitudes, knowledge and perception of primary care physicians towards genetic counseling and testing for hereditary breast cancer were examined. A questionnaire was sent to 1391 primary care physicians in private practice in the German-speaking Canton of Zürich. 628 (45%) questionnaires were returned: 319/778 (41%) general practitioners, 156/367 (43%) internists, 118/218 (54%) obstetrician-gynecologists and 22/28 (76%) oncologists answered. Socio-demographic characteristics were: 74% males and 26% females with a mean age of 51 and a mean number of 14 years in private practice. Fifty-two percent of responding physicians approved of genetic susceptibility testing and seventy-seven percent would recommend it to individuals at risk if asked for it. Of the responding physicians, 47% wanted to disclose test results and discuss its consequences and 79% wanted to provide long term care and support, whereas only 36% and 9%, respectively, assigned these tasks to specialized cancer genetics services. Eight knowledge questions had to be answered: 290 (46%) gave 0-2 correct answers, 284 (45%) gave 3-5 and 54 (9%) gave 6-8 correct answers. Our findings demonstrate that the majority of responding primary care physicians in the Canton of Zürich approve of genetic testing for hereditary breast cancer and want to play a central role in the management of these families, but lack the knowledge to do so efficiently. Our findings underline the importance of educational programs in cancer genetics.