Escher M, Sappino A P
Division of Clinical Pharmacology, Geneva University Hospital, Switzerland.
Ann Oncol. 2000 Sep;11(9):1131-5. doi: 10.1023/a:1008319114278.
Primary health care providers are expected to be directly involved in the genetic testing for cancer susceptibility. This study assessed physicians' knowledge, attitude and perception of their role towards testing for hereditary breast ovarian cancer.
A mail-in survey was sent to all general practitioners, internists, obstetrician-gynecologists and oncologists in private practice in Geneva county, Switzerland. Questions included socio-demographic variables, knowledge about hereditary breast ovarian cancer, attitude towards testing and assessment of their role in the pre- and post-test procedure.
Two hundred fifty-nine (65%) of four hundred questionnaires were returned of which two hundred forty-three (61%) were analysed. Response rates were similar between specialties; women answered more frequently. The majority 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 felt they had an active part to play in the pre-test procedure, the disclosure of results, and especially the consultants' long-term care and support (99%). Physicians correctly answered a third (32%) of the knowledge questions. 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.
The majority of the primary care physicians in this study have a favourable attitude and are ready to play a prominent role in genetic counseling and testing for breast ovarian cancer predisposition. Defective knowledge scores, however, underline the need for targeted educational programs.
初级医疗保健提供者应直接参与癌症易感性的基因检测。本研究评估了医生对遗传性乳腺癌和卵巢癌检测的知识、态度以及对自身角色的认知。
向瑞士日内瓦县所有私人执业的全科医生、内科医生、妇产科医生和肿瘤学家发送了一份邮寄调查问卷。问题包括社会人口统计学变量、关于遗传性乳腺癌和卵巢癌的知识、对检测的态度以及对他们在检测前和检测后程序中角色的评估。
400份问卷中有259份（65%）被退回，其中243份（61%）被分析。各专业的回复率相似；女性回复更为频繁。大多数受访者（87%）赞成进行基因易感性检测。对检测最常见的反对意见是缺乏预防和早期乳腺癌检测的批准策略。大多数医生认为他们在检测前程序、结果披露，尤其是在咨询者的长期护理和支持方面（99%）可以发挥积极作用。医生正确回答了三分之一（32%）的知识问题。单个项目的弃权率在13%至60%之间。得分因专业而异。肿瘤学家比妇科医生、内科医生和全科医生知识更丰富。
本研究中的大多数初级保健医生态度积极，愿意在遗传性乳腺癌和卵巢癌易感性的遗传咨询和检测中发挥重要作用。然而，知识得分较低凸显了针对性教育项目的必要性。
