Patterns of Cancer Genetic Testing: A Randomized Survey of Oregon Clinicians

Patterns of Cancer Genetic Testing: A Randomized Survey of Oregon Clinicians
Journal of Cancer Epidemiology
Volume 2012 (2012), Article ID 294730, 11 pages
doi:10.1155/2012/294730

Research ArticlePatterns of Cancer Genetic Testing: A Randomized Survey of Oregon Clinicians
Summer L. Cox,1 Amy I. Zlot,1 Kerry Silvey,1,2 Debi Elliott,3 Tara Horn,3 Amber Johnson,3 and Richard F. Leman41Oregon Genetics Program, Public Health Division, Oregon Health Authority, Portland, OR 97232,  USA
2Oregon Center for Children and Youth with Special Health Needs, Child Development and Rehabilitation Center, Oregon Health & Science University, Portland, OR 97239,  USA
3Survey Research Lab, Office of Research and Sponsored Projects, Portland State University, Portland, OR 97201,  USA
4Center for Public Health Practice, Public Health Division, Oregon Health Authority, Portland, OR 97232,  USAReceived 16 March 2012; Revised 11 June 2012; Accepted 12 June 2012Academic Editor: Suzanne C. O'Neill Copyright © 2012 Summer L. Cox et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.AbstractIntroduction. Appropriate use of genetic tests for population-based cancer screening, diagnosis of inherited cancers, and guidance of cancer treatment can improve health outcomes. We investigated clinicians’ use and knowledge of eight breast, ovarian, and colorectal cancer genetic tests. Methods. We conducted a randomized survey of 2,191 Oregon providers, asking about their experience with fecal DNA, OncoVue, BRCA, MMR, CYP2D6, tumor gene expression profiling, UGT1A1, and KRAS. Results. Clinicians reported low confidence in their knowledge of medical genetics; most confident were OB-GYNs and specialists. Clinicians were more likely to have ordered/recommended BRCA and MMR than the other tests, and OB-GYNs were twice as likely to have ordered/recommended BRCA testing than primary care providers. Less than 10% of providers ordered/recommended OncoVue, fecal DNA, CYP2D6, or UGT1A1; less than 30% ordered/recommended tumor gene expression profiles or KRAS. The most common reason for not ordering/recommending these tests was lack of familiarity. Conclusions. Use of appropriate, evidence-based testing can help reduce incidence and mortality of certain cancers, but these tests need to be better integrated into clinical practice. Continued evaluation of emerging technologies, dissemination of findings, and an increase in provider confidence and knowledge are necessary to achieve this end.