Skip to main content
NCBI home page
Canadian Family Physician logoLink to Canadian Family Physician
. 2003 Jan;49:45–52.

Genetic susceptibility to cancer. Family physicians' experience.

June C Carroll 1, Judith Belle Brown 1, Sean Blaine 1, Gord Glendon 1, Patricia Pugh 1, Wendy Medved 1
PMCID: PMC2214120  PMID: 12602842

Abstract

OBJECTIVE: To explore family physicians' experiences in dealing with genetic susceptibility to cancer. DESIGN: Qualitative study using focus groups. SETTING: Four Ontario sites: northern, rural, urban, and inner city. PARTICIPANTS: Forty rural and urban FPs participated in four focus groups: 28 were male; average age was 41. METHOD: Focus groups using a semistructured interview guide were audiotaped and transcribed. The constant comparative method of data analysis was used. Key words and concepts were identified. Data were sorted using NUD*IST software. MAIN FINDINGS: Participants realized the escalating expectations for genetic testing and its effect on family practice. They explored an expanded role for themselves in genetic testing. Possible activities included risk assessment, gatekeeping, and ordering genetic tests. They were concerned about the complexity of genetic testing, the lack of evidence regarding management, and the implications for families. CONCLUSION: We must help FPs struggling to integrate genetics into their practices, by addressing their concerns, enhancing the way they communicate information on genetics, and developing appropriate educational tools.

Full Text

The Full Text of this article is available as a PDF (196.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrykowski M. A., Lightner R., Studts J. L., Munn R. K. Hereditary cancer risk notification and testing: how interested is the general population? J Clin Oncol. 1997 May;15(5):2139–2148. doi: 10.1200/JCO.1997.15.5.2139. [DOI] [PubMed] [Google Scholar]
  2. Carroll J. C., Heisey R. E., Warner E., Goel V., McCready D. R. Hereditary breast cancer. Psychosocial issues and family physicians' role. Can Fam Physician. 1999 Jan;45:126–132. [PMC free article] [PubMed] [Google Scholar]
  3. Carroll J. C., Reid A. J., Woodward C. A., Permaul-Woods J. A., Domb S., Ryan G., Arbitman S., Fallis B., Kilthei J. Ontario Maternal Serum Screening Program: practices, knowledge and opinions of health care providers. CMAJ. 1997 Mar 15;156(6):775–784. [PMC free article] [PubMed] [Google Scholar]
  4. Chaliki H., Loader S., Levenkron J. C., Logan-Young W., Hall W. J., Rowley P. T. Women's receptivity to testing for a genetic susceptibility to breast cancer. Am J Public Health. 1995 Aug;85(8 Pt 1):1133–1135. doi: 10.2105/ajph.85.8_pt_1.1133. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Emery J., Hayflick S. The challenge of integrating genetic medicine into primary care. BMJ. 2001 Apr 28;322(7293):1027–1030. doi: 10.1136/bmj.322.7293.1027. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Emery J., Watson E., Rose P., Andermann A. A systematic review of the literature exploring the role of primary care in genetic services. Fam Pract. 1999 Aug;16(4):426–445. doi: 10.1093/fampra/16.4.426. [DOI] [PubMed] [Google Scholar]
  7. Escher M., Sappino A. P. Primary care physicians' knowledge and attitudes towards genetic testing for breast-ovarian cancer predisposition. Ann Oncol. 2000 Sep;11(9):1131–1135. doi: 10.1023/a:1008319114278. [DOI] [PubMed] [Google Scholar]
  8. Firth H. V., Lindenbaum R. H. UK clinicians' knowledge of and attitudes to the prenatal diagnosis of single gene disorders. J Med Genet. 1992 Jan;29(1):20–23. doi: 10.1136/jmg.29.1.20. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Fry A., Campbell H., Gudmunsdottir H., Rush R., Porteous M., Gorman D., Cull A. GPs' views on their role in cancer genetics services and current practice. Fam Pract. 1999 Oct;16(5):468–474. doi: 10.1093/fampra/16.5.468. [DOI] [PubMed] [Google Scholar]
  10. Geller G., Tambor E. S., Chase G. A., Hofman K. J., Faden R. R., Holtzman N. A. Incorporation of genetics in primary care practice. Will physicians do the counseling and will they be directive? Arch Fam Med. 1993 Nov;2(11):1119–1125. doi: 10.1001/archfami.2.11.1119. [DOI] [PubMed] [Google Scholar]
  11. Geller Gail, Holtzman Neil A. Implications of the human genome initiative for the primary care physician. Bioethics. 1991 Oct;5(4):318–325. doi: 10.1111/j.1467-8519.1991.tb00172.x. [DOI] [PubMed] [Google Scholar]
  12. Hunter A., Wright P., Cappelli M., Kasaboski A., Surh L. Physician knowledge and attitudes towards molecular genetic (DNA) testing of their patients. Clin Genet. 1998 Jun;53(6):447–455. doi: 10.1111/j.1399-0004.1998.tb02593.x. [DOI] [PubMed] [Google Scholar]
  13. Kolb S. E., Aguilar M. C., Dinenberg M., Kaye C. I. Genetics education for primary care providers in community health settings. J Community Health. 1999 Feb;24(1):45–59. doi: 10.1023/a:1018765215470. [DOI] [PubMed] [Google Scholar]
  14. Lucassen A., Watson E., Harcourt J., Rose P., O'Grady J. Guidelines for referral to a regional genetics service: GPs respond by referring more appropriate cases. Fam Pract. 2001 Apr;18(2):135–140. doi: 10.1093/fampra/18.2.135. [DOI] [PubMed] [Google Scholar]
  15. Macdonald K. G., Doan B., Kelner M., Taylor K. M. A sociobehavioural perspective on genetic testing and counselling for heritable breast, ovarian and colon cancer. CMAJ. 1996 Feb 15;154(4):457–464. [PMC free article] [PubMed] [Google Scholar]
  16. Menasha J. D., Schechter C., Willner J. Genetic testing: a physician's perspective. Mt Sinai J Med. 2000 Mar;67(2):144–151. [PubMed] [Google Scholar]
  17. Mountcastle-Shah E., Holtzman N. A. Primary care physicians' perceptions of barriers to genetic testing and their willingness to participate in research. Am J Med Genet. 2000 Oct 23;94(5):409–416. doi: 10.1002/1096-8628(20001023)94:5<409::aid-ajmg13>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  18. O'Malley M. S., Klabunde C. N., McKinley E. D., Newman B. Should we test women for inherited susceptibility to breast cancer? what do NC primary care physicians think. N C Med J. 1997 May-Jun;58(3):176–180. [PubMed] [Google Scholar]
  19. Warner Ellen, Goel Vivek, Ondrusek Nancy, Thiel Elaine C., Lavina H., Lickley A., Chart Pamela L., Meschino Wendy S., Doan Brian D., Carroll June C. Pilot study of an information aid for women with a family history of breast cancer. Health Expect. 1999 May;2(2):118–128. doi: 10.1046/j.1369-6513.1999.00038.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Watson E. K., Shickle D., Qureshi N., Emery J., Austoker J. The 'new genetics' and primary care: GPs' views on their role and their educational needs. Fam Pract. 1999 Aug;16(4):420–425. doi: 10.1093/fampra/16.4.420. [DOI] [PubMed] [Google Scholar]
  21. Watson E., Austoker J., Lucassen A. A study of GP referrals to a family cancer clinic for breast/ovarian cancer. Fam Pract. 2001 Apr;18(2):131–134. doi: 10.1093/fampra/18.2.131. [DOI] [PubMed] [Google Scholar]
  22. Whittaker L. A. The implications of the Human Genome Project for family practice. J Fam Pract. 1992 Sep;35(3):294–301. [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES