Knowledge, attitudes and behavior of physicians regarding predictive genetic tests for breast and colorectal cancer

Marzuillo, Carolina; Vito, Corrado De; Boccia, Stefania; D’Addario, M; D’Andrea, Elvira; Santini, P.; Boccia, Antonio; Villari, Paolo

doi:10.1016/j.ypmed.2013.06.022

Cited by 50 publications

(67 citation statements)

References 34 publications

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“…In this context, doctors have been envisaged as the key players in properly incorporating emerging DNA technologies in the health care system [3, 4], leading to calls for enhanced genomic education for healthcare professionals. Nevertheless, several studies conducted in USA, Europe, and Canada showed unsatisfactory level of clinicians' ability to use genetic tests in clinical care [3–5]. …”

Section: Introductionmentioning

confidence: 99%

“…However, Marzuillo et al reported a significant lack of knowledge on BRCA1/2 and APC tests among Italian medical doctors [5], irrespective of their specialty. Along similar lines, we conducted survey on Italian doctors attending postgraduate medical schools in order to examine the level of education they had received on genetic tests for breast and colorectal cancer during their recent medical training.…”

Section: Introductionmentioning

confidence: 99%

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Survey on Knowledge, Attitudes, and Training Needs of Italian Residents on Genetic Tests for Hereditary Breast and Colorectal Cancer

Panić

Leoncini

Giannantonio

et al. 2014

BioMed Research International

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Objectives. The aim of the study was to assess knowledge and attitudes of medical residents working in Università Cattolica del Sacro Cuore, Rome, Italy, on genetic tests for breast and colorectal cancer. Methods. We distributed self-administered questionnaire to the residents. Logistic regression models were used to evaluate the determinants of knowledge and attitudes towards the tests. Results. Of 754 residents, 364 filled in questionnaire. Around 70% and 20% answered correctly >80% of questions on breast and colorectal cancer tests, respectively. Knowledge on tests for breast cancer was higher among residents who attended course on cancer genetic testing during graduate training (odds ratio (OR): 1.72; 95% confidence interval (CI): 1.05–2.82) and inversely associated with male gender (OR: 0.55; 95% CI: 0.35–0.87). As for colorectal cancer, residents were more knowledgeable if they attended courses on cancer genetic testing (OR: 2.08; 95% CI: 1.07–4.03) or postgraduate training courses in epidemiology and evidence-based medicine (OR: 1.95; 95% CI: 1.03–3.69). More than 70% asked for the additional training on the genetic tests for cancer during the specialization school. Conclusion. The knowledge of Italian residents on genetic tests for colorectal cancer appears to be insufficient. There is a need for additional training in this field.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survey on Knowledge, Attitudes, and Training Needs of Italian Residents on Genetic Tests for Hereditary Breast and Colorectal Cancer

Panić

Leoncini

Giannantonio

et al. 2014

BioMed Research International

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“…Compared with Italian physicians, who previously showed significant training needs in the field of efficacy, effectiveness and economic evaluation of health interventions [42,43], public health attitudes towards predictive genetic testing appear to be more positive among public health practitioners. For example, the percentage of public health professionals who agree that the selection of predictive genetic testing to be delivered to the population should be based on the principles of efficacy and cost-effectiveness are higher than those found among Italian physicians in another survey [44]. Globally, the public health community in Italy appears to be more prepared than physicians for a responsible and appropriate introduction of DNA-technology into health care and public health practice.…”

Section: Discussionmentioning

confidence: 94%

Are public health professionals prepared for public health genomics? A cross-sectional survey in Italy

Marzuillo

Vito

D’Addario

et al. 2013

European Journal of Public Health

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Background: Public health genomics is an emerging multidisciplinary approach, which aims to integrate genome-based knowledge in a responsible and effective way into public health. Despite several surveys performed to evaluate knowledge, attitudes and professional behaviors of physicians towards predictive genetic testing, similar surveys have not been carried out for public health practitioners. This study is the first to assess knowledge, attitudes and training needs of public health professionals in the field of predictive genetic testing for chronic diseases. Methods: A self-administered questionnaire was used to carry out a cross-sectional survey of a random sample of Italian public health professionals. Results: A response rate of 67.4% (797 questionnaires) was achieved. Italian public health professionals have the necessary attitudinal background to contribute to the proper use of predictive genetic testing for chronic diseases, but they need additional training to increase their methodological knowledge. Knowledge significantly increases with exposure to predictive genetic testing during postgraduate training (odds ratio (OR) = 1.74, 95% confidence interval (CI) = 1.05-2.88), time dedicated to continuing medical education (OR = 1.53, 95% CI = 1.14-2.04) and level of English language knowledge (OR = 1.36, 95% CI = 1.07-1.72). Adequate knowledge is the strongest predictor of positive attitudes from a public health perspective (OR = 3.98, 95% CI = 2.44-6.50). Physicians show a lower level of knowledge and more public health attitudes than other public health professionals do. About 80% of public health professionals considered their knowledge inadequate and 86.0% believed that it should be improved through specific postgraduate training courses. Conclusions: Specific and targeted training initiatives are needed to develop a skilled public health workforce competent in identifying genomic technology that is ready for use in population health and in modeling public health genomic programs and primary care services that need to be developed, implemented and evaluated.

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“…Other reported barriers to clinicians' referral for cancer genetic risk evaluation include the limited knowledge on hereditary cancer and the lack of specific training [23,24]. Indeed, a recent survey indicates that the knowledge of and attitudes about BRCA genetic testing of Italian physicians are heterogeneous [25], suggesting that targeted educational and training programs in this field are needed in our country.…”

Section: Discussionmentioning

confidence: 99%

Referral of Ovarian Cancer Patients for Genetic Counselling by Oncologists: Need for Improvement

Ricci

Sciallero²,

Mammoliti³

et al. 2015

Public Health Genomics

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Background/Aims: Nearly 15% of all ovarian cancer patients carry a germline BRCA mutation. A pilot project was started at IRCCS AOU San Martino - IST, Genoa, to assess the feasibility and consequences of offering genetic counselling to all ovarian cancer patients during routine oncology appointments. We present early results of this project. Methods: Patients who attended an oncology visit at the Medical Oncology Unit 1 between November 2012 and December 2013 were identified. Medical records were reviewed for clinical data, genetic counselling and testing outcomes. Results: Out of 104 women diagnosed with ovarian cancer undergoing an oncology visit, 94 had not had genetic counselling in the past. Twenty-nine patients (29/94, 31%) were referred to the Unit of Hereditary Cancer; of these, 14/26 (54%) were referred at the first visit and 15/68 (22%) at the follow-up visit (p = 0.003). Most referred women attended genetic counselling (22/29, 76%) and had BRCA genetic testing (21/22, 95%). Four BRCA1 mutations were detected (4/21, 19%). Conclusions: Oncologists discuss genetic counselling with a minority of ovarian cancer patients. Mainstreaming such practice is important to optimize the management of these patients and their families. Efforts are needed to identify new models for introducing ovarian cancer genetic risk assessment in oncology practice.

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Knowledge, attitudes and behavior of physicians regarding predictive genetic tests for breast and colorectal cancer

Abstract: Targeted educational programs are needed to improve the expertise of physicians, and, ultimately, to enhance the appropriate use of genetic tests in clinical practice.

Cited by 50 publications

References 34 publications

Survey on Knowledge, Attitudes, and Training Needs of Italian Residents on Genetic Tests for Hereditary Breast and Colorectal Cancer

Survey on Knowledge, Attitudes, and Training Needs of Italian Residents on Genetic Tests for Hereditary Breast and Colorectal Cancer

Are public health professionals prepared for public health genomics? A cross-sectional survey in Italy

Referral of Ovarian Cancer Patients for Genetic Counselling by Oncologists: Need for Improvement

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