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Many Doctors Ignore Cancer Genetic Testing Guidelines

MONDAY July 25, 2011 -- Many doctors are not following guidelines on genetic counseling and testing for women at average and high risk for breast and ovarian cancer, according to a new study.

This lack of compliance could result in women missing out on treatments that could reduce their chances of developing these diseases, the researchers pointed out in a report published in the July 25 online edition of the journal Cancer.

"Despite the existence of evidence-based guidelines on referral for genetic counseling and testing for hereditary breast and ovarian cancer, many physicians report practices contrary to these recommendations," Katrina Trivers, of the U.S. Centers for Disease Control and Prevention, said in a journal news release.

Women with mutations in the BRCA1 or BRCA2 gene or family histories of these mutations are at significantly greater risk for breast and ovarian cancer. Genetic counseling and testing are recommended for high-risk women because there are treatments that could significantly lower their risk for the diseases. These services are not recommended, however, for women who are not considered high-risk, because the harms of treatment outweigh the benefits, the study authors explained.

For the study, 1,878 U.S. family physicians, general internists and obstetrician-gynecologists responded to a survey about the services they provide to women during annual exams. More specifically, the researchers asked the doctors how frequently they refer women to genetic counseling or offer BRCA1/BRCA2 testing. The investigators also sought to determine if the doctors' answers would vary based on their female patients' age, race, insurance status or ovarian cancer risk.

The study found that only 41 percent of physicians said they would refer high-risk women for genetic counseling or testing. Meanwhile, contrary to guidelines, 29 percent of doctors said they would sometimes or always refer average-risk women.

Trivers and colleagues concluded that more efforts are needed to ensure that only high-risk women receive these services. They also noted that doctors said they are more likely to follow current recommendations when they can accurately assess their patients' risks of cancer.

More information

The U.S. National Cancer Institute provides more information on women's cancer risk and genetic testing.

Posted: July 2011


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