Table 3.
Motivators and barriers of referral of patients suspected with Lynch syndrome for genetic services *.
| Have not Referred for Genetic Services (Total = 30) N (%) a | Referred for Genetic Services (Total = 112) N (%) a | p-value b | |||
|---|---|---|---|---|---|
| Motivators | |||||
| To provide genetic counselling for the patient | 20 | (66) | 103 | (92) | <0.001 |
| Patient interest or request | 20 | (66) | 92 | (82) | 0.065 |
| To provided appropriate screening and/or management for the patient’s family | 15 | (50) | 94 | (84) | <0.001 |
| To provide appropriate cancer risk assessments for the patient | 21 | (70) | 98 | (88) | 0.544 |
| To provide genetic testing for germline mutations | 14 | (47) | 83 | (74) | 0.004 |
| Reassurance for the patient and family | 16 | (53) | 73 | (65) | 0.234 |
| Ethical and legal responsibility | 14 | (47) | 70 | (63) | 0.117 |
| To provide appropriate screening and management for the patient | 20 | (66) | 81 | (72) | 0.544 |
| Others c | 0 | 5 | (4) | - | |
| Barriers | |||||
| Patient was not interested when referral was offered | 17 | (57) | 62 | (55) | 0.898 |
| Patient may be at risk for insurance discrimination | 5 | (17) | 19 | (17) | 0.969 |
| Recommendations and guidelines were not available to select patients for referral | 8 | (27) | 11 | (10) | 0.016 |
| Patient is unlikely to benefit from genetic counselling/testing | 1 | (3) | 16 | (14) | 0.123 |
| I do not feel familiar with hereditary cancer syndromes | 5 | (17) | 6 | (5) | 0.040 |
| Long waiting time for appointment at genetics clinic | 2 | (7) | 7 | (6) | 0.934 |
| I do not know how to make a referral to the local genetic health service | 7 | (23) | 1 | (1) | <0.001 |
| I do not have access to genetic health service | 6 | (20) | 2 | (2) | 0.001 |
| I do not feel it is my responsibility | 2 | (7) | 1 | (1) | 0.113 |
| Others d | 0 | 4 | (4) | - | |
* For referral to genetic services, total respondents were 142 in total. a The % reflects the percent responding within each category; b Bolded estimates indicate significant findings between clinicians who have referred (n = 112) and did not refer (n = 30) patients for genetic services; c Qualitative answers were provided, which include antenatal diagnosis, significant family history, significant tumour testing results, to provide the necessary routine surveillance and advice regarding screening and risk-reducing options for patients; d Qualitative answers were provided, which include lack of resources and no prophylactic treatment or screening available for patients.