Knowledge, attitudes and behavior of physicians regarding predictive genetic tests for breast and colorectal cancer

Prev Med. 2013 Nov;57(5):477-82. doi: 10.1016/j.ypmed.2013.06.022. Epub 2013 Jul 1.

Abstract

Background: Genetic testing for cancer susceptibility is an emerging technology in medicine. This study assessed the knowledge, attitudes and professional behavior of Italian physicians regarding the use of predictive genetic tests for breast and colorectal cancer, including the BRCA1/2 and APC tests.

Methods: A cross-sectional survey of a random sample of Italian physicians was performed in 2010 through a self-administered questionnaire.

Results: A response rate of 69.6% (1079 questionnaires) was achieved. A significant lack of knowledge was detected, particularly for APC testing. Less than half of the physicians agreed on the importance of efficacy and cost-effectiveness evidence in the selection of predictive genetic tests to be offered to the patients. Multiple logistic regression analyses showed that education had a positive influence on knowledge, attitudes and, to a lesser extent, professional use. The factor most strongly related to the physicians' use of genetic testing was patients requests for breast (odds ratio=12.65; 95% confidence interval 7.77-20.59) or colorectal cancer tests (odds ratio=7.02; 95% confidence interval 3.61-13.64). A high level of interest for specific training was reported by almost all physicians surveyed.

Conclusions: Targeted educational programs are needed to improve the expertise of physicians, and, ultimately, to enhance the appropriate use of genetic tests in clinical practice.

Keywords: Attitudes; Cancer predictive genetic tests; Cross-sectional survey; Knowledge; Physicians; Professional behavior.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenomatous Polyposis Coli Protein / genetics
  • Adult
  • Attitude of Health Personnel*
  • BRCA1 Protein / genetics
  • BRCA2 Protein / genetics
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / prevention & control*
  • Colorectal Neoplasms / genetics*
  • Colorectal Neoplasms / prevention & control*
  • Cross-Sectional Studies
  • Female
  • Genetic Predisposition to Disease / genetics
  • Genetic Testing / statistics & numerical data*
  • Health Policy
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Surveys and Questionnaires
  • Utilization Review

Substances

  • APC protein, human
  • Adenomatous Polyposis Coli Protein
  • BRCA1 Protein
  • BRCA1 protein, human
  • BRCA2 Protein
  • BRCA2 protein, human