Many doctors are not following guidelines on genetic counselling and testing for women at average and high risk for breast and ovarian cancer, according to a new study.
This lack of compliance could result in women missing out on treatments that could reduce their chances of developing these diseases, the researchers pointed out in a report published in the journal Cancer.
"Despite the existence of evidence-based guidelines on referral for genetic testing for hereditary breast and ovarian cancer, many physicians report practises contrary to these recommendations," Katrina Trivers, of the US Centers for Disease Control and Prevention, said.
Women with mutations in the BRCA1 or BRCA2 gene or family histories of these mutations are at significantly greater risk for breast and ovarian cancer. Genetic counselling and testing are recommended for high-risk women because there are treatments that could significantly lower their risk for the diseases. These services are not recommended, however, for women who are not considered high-risk, because the harms of treatment outweigh the benefits, the study authors explained.
Doctors and genetic testing
For the study, 1,878 US family physicians, general internists and obstetrician-gynaecologists responded to a survey about the services they provide to women during annual exams. More specifically, the researchers asked the doctors how frequently they refer women to genetic counselling or offer BRCA1/BRCA2 testing. The investigators also sought to determine if the doctors' answers would vary based on their female patients' age, race, insurance status or ovarian cancer risk.
The study found that only 41% of physicians said they would refer high-risk women for genetic counselling or testing. Meanwhile, contrary to guidelines, 29% of doctors said they would sometimes or always refer average-risk women.
Trivers and colleagues concluded that more efforts are needed to ensure that only high-risk women receive these services. They also noted that doctors said they are more likely to follow current recommendations when they can accurately assess their patients' risks of cancer.
The U.S. National Cancer Institute provides more information on women's cancer risk and genetic testing.
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