A survey of 1,878 U.S. family physicians, general internists, and obstetricians/gynecologists suggests that these providers would refer many women at average risk of ovarian cancer for genetic counseling and BRCA 1/2 testing but not many high-risk women. The finding directly opposes current recommendations.
The survey included an annual examination vignette posing questions about patients in various age, race, insurance status, and ovarian cancer risk categories. Just over 70% of respondents reported adherence to recommendations against genetic counseling or BRCA 1/2 testing for women at average risk.
Predictors of adherence to recommendations against referral/testing included African American versus Caucasian race, Medicaid versus private insurance, and rural versus urban location. Adherence to recommendations to refer high-risk women for genetic counseling or testing was self-reported among 41% physician participants. Younger patient age (35 vs 51), physician sex (female vs male), and OB/GYN versus family medicine specialty were predictors of adherence for referral/testing. Physician-estimated ovarian cancer risk was the most powerful predictor of adherence to recommendations for both average- and high-risk women.
The study authors concluded that intervention efforts, “including promotion of accurate risk assessment, are needed.”
Physician’s Weekly wants to know…
• Do you feel rates adherence to recommendations for ovarian cancer-based genetic counseling/testing are low, as the survey findings suggest?
• What interventions do you think can be made to improve adherence to genetic counseling and BRCA 1/2 testing?