Differential Use of Available Genetic Tests among Primary Care Physicians in the U.S.: Results of a National Survey

Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Massachusetts General Hospital/Partners HealthCare, Boston, Massachusetts, USA.
Genetics in medicine: official journal of the American College of Medical Genetics (Impact Factor: 6.44). 07/2008; 10(6):404-14. DOI: 10.1097/GIM.0b013e3181770184
Source: PubMed

ABSTRACT This study assesses primary care physicians' experience ordering and referring patients for genetic testing, and whether minority-serving physicians are less likely than those serving fewer minorities to offer such services.
Survey of a random sample of 2000 primary care physicians in the United States (n = 1120, 62.3% response rate based on eligible respondents) conducted in 2002 to assess what proportion have (1) ever ordered a genetic test in general or for select conditions; (2) ever referred a patient for genetic testing to a genetics center or counselor, a specialist, a clinical research trial, or to any site of care.
Nationally, 60% of primary care physicians have ordered a genetic test and 74% have referred a patient for genetic testing. Approximately 62% of physicians have referred a patient for genetic testing to a genetics center/counselor or to a specialist, and 17% to a clinical trial. Minority-serving physicians were significantly less likely to have ever ordered a genetic test for breast cancer, colorectal cancer, or Huntington disease, or to have ever referred a patient for genetic testing relative to those serving fewer minorities.
Reduced utilization of genetic tests/referrals among minority-serving physicians emphasizes the importance of tracking the diffusion of genomic medicine and assessing the potential impact on health disparities.

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Available from: Douglas E Levy, Jul 25, 2014
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    • "Despite this, several surveys performed in the U.S., Europe and Canada show that doctors are not prepared for the increasing use of genetics in clinical care (Acton et al., 2000; Batra et al., 2002; Bellcross et al., 2011; Bethea et al., 2008; Burke et al., 2009; Carroll et al., 2008; Escher and Sappino, 2000; Freedman et al., 2003; Klitzman et al., 2012; Mehnert et al., 2003; Nippert et al., 2011; Pichert et al., 2003; Sabatino et al., 2007; Shields et al., 2008; Sifri et al., 2003; Toiviainen and Hemminki, 2001; Trivers et al., 2011; Van Riel et al., 2010; Welkenhuysen and Evers-Kiebooms, 2002; White et al., 2008; Wideroff et al., 2003; Wideroff et al., 2005; Wilkins-Haug et al., 2000). Many physicians do not have any specific education and the vast majority does not feel they have the needed training and knowledge for the appropriate use of genetic testing to guide prevention or treatment decisions (Anon, 2011; Feero and Green, 2011). "
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    • "They would therefore be more likely to seek genetic counselling or ask their GP for a referral. Additionally, different cultural values concerning genetics might explain fewer requests for counselling and physicians might assume that patients from other than Caucasian ethnicities would not be interested (Shields et al. 2008). Also, similarities in counselees' information needs have been found. "
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    • "These cultural mores and beliefs about cancer can pose powerful barriers to open communication about a cancer diagnosis in Hispanic families (Orom et al. 2007). It has also been noted that in some countries, including those with Hispanic groups, there is a personal preference for not disclosing cancer diagnosis and prognosis information to other family members (Shields et al. 2008). Thus, this nondisclosure severely impacts communication about family history of cancer. "
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