Education of the Healthcare Providers

As the genetic contribution to cancer continues to evolve, primary care providers will assume a more pivotal role in the provision of clinical genetic services, including providing education to patients and their families about genetic information in general, genetic testing in particular, and the use of genetic technologies in cancer risk reduction surveillance, diagnosis, and treatment. The involvement of the entire healthcare team will be critical to assess the outcomes of family decisions regarding genetic information and to guide individuals and their families through the complex world of cancer genetics. There are data to suggest, however, that among members of the healthcare profession, knowledge regarding the criteria for hereditary cancer syndromes, the indications for associated genetic testing, and the role that molecular genetics plays in the prevention, diagnosis, and treatment of cancer is limited. A nationally representative random sample of physicians in primary and tertiary care specialties found that fewer than one-third of physicians had recommended cancer genetic testing to a patient. Barriers to the use of genetic tests in their patient populations included lack of confidence in their ability to recommend testing and lack of access to counseling and testing services.12 Healthcare providers are often at a loss about how to understand and communicate genetic test results to individuals, about what is their responsibility to inform other at-risk relatives of their potential genetic risk, and about how to assure confidentiality and privacy of genetic information in the medical record system. Limited physician knowledge of genetics may pose a barrier to the referral of appropriate candidates for genetic testing and the standard utilization of genetic predictive testing in clinical practice for increased cancer surveillance, screening, and prevention. Based on the potential for identification, classification, prevention, and treatment for a wide variety of cancer types, physicians and other healthcare providers and their patients would greatly benefit from training in interpretation and use of genetic predisposition testing as part of their clinical practice.

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