Patterns of Cancer Genetic Testing: A Randomized Survey of Oregon Clinicians

[摘要] Introduction. Appropriate use of genetic tests for population-based cancer screening, diagnosis of inherited cancers, and guidance of cancer treatment can improve health outcomes. We investigated clinicians’ use and knowledge of eight breast, ovarian, and colorectal cancer genetic tests.Methods. We conducted a randomized survey of 2,191 Oregon providers, asking about their experience with fecal DNA, OncoVue,BRCA,MMR,CYP2D6, tumor gene expression profiling,UGT1A1, andKRAS.Results. Clinicians reported low confidence in their knowledge of medical genetics; most confident were OB-GYNs and specialists. Clinicians were more likely to have ordered/recommendedBRCAandMMRthan the other tests, and OB-GYNs were twice as likely to have ordered/recommendedBRCAtesting than primary care providers. Less than 10% of providers ordered/recommended OncoVue, fecal DNA,CYP2D6, orUGT1A1; less than 30% ordered/recommended tumor gene expression profiles orKRAS. The most common reason for not ordering/recommending these tests was lack of familiarity.Conclusions. Use of appropriate, evidence-based testing can help reduce incidence and mortality of certain cancers, but these tests need to be better integrated into clinical practice. Continued evaluation of emerging technologies, dissemination of findings, and an increase in provider confidence and knowledge are necessary to achieve this end.

[学科分类] 流行病学