A survey of the practice patterns of gynecologic oncologists dealing with hereditary cancer patients in Japan

Abstract

Hereditary breast and ovarian cancer syndrome (HBOC) is a significant type of familial ovarian cancer. A survey of gynecologic oncologists was conducted in order to characterize the state of care and awareness of information provision for HBOC in Japan and to identify information necessary to enhance HBOC care. All gynecologic oncologists certified by the Japan Society of Gynecologic Oncology (JSGO) as specialists in the treatment of ovarian cancer were included. They were sent a 44-question questionnaire dealing with the background of the respondent, the facilities at the respondent's medical institution, how the family history interview is conducted, awareness of and practice behavior toward HBOC, performance of genetic testing, and performance of risk-reducing salpingo-oophorectomy (RRSO). The response rate was 50.1 %. About 60 % of respondents stated that "I administer care with HBOC in mind" and "I want to be involved in the care of HBOC." However, only 2 in 3 doctors was able to explain HBOC to patients, fewer than 1 in 5 doctors was able to give counseling to patients, 1 in 10 doctors provided printed information to patients suspected of having a hereditary cancer, and 1 in 7 doctors recommended that patients suspected of having a hereditary cancer visit the department of genetics. The provision of information to patients, recommending that patients visit the department of genetics, and the performance of genetic testing were dependent on whether a department of genetics was present in the respondent's institution. The survey also found that RRSO is not widely performed in Japan.

Mainstreaming genetics and genomics: a systematic review of the barriers and facilitators for nurses and physicians in secondary and tertiary care

“…Knowledge and Skill: 27 articles (56%) explored nurses' and physicians' knowledge of genetics (9, 26, 28-52), while 41 articles (85%) reported on their skills (9, 21-25, 27-35, 37-47, 49-63). While nurses and physicians routinely engaged in discussions about genetics with their patients (22,24,29,31,38,42,47,49,(52)(53)(54)(55)(56), all demonstrated limited understanding of general genetic concepts, and/or concepts relevant to their specialty (26,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). Despite knowledge deficits, nurses and physicians did engage in discussions about genetics with their patients (22,24,29,31,38,42,47,49,(52)(53)(54)(55)(56).…”

“…Despite knowledge deficits, nurses and physicians did engage in discussions about genetics with their patients (22,24,29,31,38,42,47,49,(52)(53)(54)(55)(56). In some specialties, family history information was routinely obtained (21,29,30,32,33,38,39,47,49,(52)(53)(54)(55), although the extent of the family history was not always adequate (28,31,32,35,39,57). A smaller number of articles reported that physicians did assess genetic risk (23,30,34,49,50,52,60,61), however, confidence in family history and individual risk assessment was low (9, 29, 32, 35, 37, 38, 40, 43-45, 49, 53, 57-59).…”

“…A smaller number of articles reported that physicians did assess genetic risk (23,30,34,49,50,52,60,61), however, confidence in family history and individual risk assessment was low (9, 29, 32, 35, 37, 38, 40, 43-45, 49, 53, 57-59). Four articles reported an inverse relationship between years of clinical practice and level of knowledge (29,32,33,38).…”

A Targeted Approach to Genetic Counseling in Breast Cancer Patients: The Experience of an Italian Local Project

“…The outcome of the study highlights the need for adequate education regarding the use of risk assessment tools for clinicians who lack specific expertise in genetic assessment. Another survey conducted among Japanese gynecologic oncologists showed that although the majority of them paid attention to hereditary BC, fewer than 1 in 5 doctors were able to provide counseling, 1 in 10 doctors provided printed information to high-risk patients, and 1 in 7 doctors recommended a visit to the department of genetics (23). Interestingly, the recommendation of genetic counseling and performance of genetic testing were dependent on whether an oncogenetics department was present in the institution.…”

Final report of the Committee on Gynecologic Oncology, the Japan Society of Obstetrics and Gynecology, on a fact‐finding questionnaire on the status of treatment of hereditary breast and ovarian cancer syndrome in Japan

“…This procedure is therefore recommended for women of appropriate age, such as those who have no wish to conceive. In Japan, the Development of Communication Program Regarding Genetic Counseling and Testing for Breast and Ovarian Cancer Patients (Research Grant of Ministry of Education, Culture, Sports, Science and Technology, 1 April 2012–31 March 2015) group carried out a fact‐finding survey on HBOC among specialists in gynecologic oncology by administering the report as “a survey of the practice patterns of gynecologic oncologists dealing with hereditary cancer patients in Japan.” The results of this study showed that a cooperative response to HBOC by obstetrician–gynecologists, clinical geneticists, and certified genetic counselors was an urgent issue. In addition, it was found that: 9.5% of facilities ( n = 306) are able to carry out RRSO; some of these facilities carry out more than 50 procedures a year; and 25% of these facilities carry out this procedure as regular medical care.…”