Background: Primary health care providers are expected to be directly invol
ved in the genetic testing for cancer susceptibility. This study assessed p
hysicians' knowledge, attitude and perception of their role towards testing
for hereditary breast-ovarian cancer.
Design: A mail-in survey was sent to all general practitioners, internists,
obstetrician-gynecologists and oncologists in private practice in Geneva c
ounty, Switzerland. Questions included socio-demographic variables, knowled
ge about hereditary breast-ovarian cancer, attitude towards testing and ass
essment of their role in the pre- and post-test procedure.
Results: Two hundred fifty-nine (65%) of four hundred questionnaires were r
eturned of which two hundred forty-three (61%) were analysed. Response rate
s were similar between specialties; women answered more frequently. The maj
ority of the respondents (87%) approved of genetic susceptibility testing.
The most common objection to testing was the absence of approved strategies
for the prevention and detection of early breast cancer. Most physicians f
elt they had an active part to play in the pre-test procedure, the disclosu
re of results, and especially the consultants' long-term care and support (
99%). Physicians correctly answered a third (32%) of the knowledge question
s. The abstention rate for individual items ranged from 13% to 60%. Scores
varied by specialty. Oncologists were more knowledgeable than gynecologists
, internists and general practitioners.
Conclusions: The majority of the primary care physicians in this study have
a favourable attitude and are ready to play a prominent role in genetic co
unseling and testing for breast-ovarian cancer predisposition. Defective kn
owledge scores, however, underline the need for targeted educational progra