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Vol. 16, No. 3, 2013
Issue release date: May 2013

Primary Care Physician Management, Referral, and Relations with Specialists Concerning Patients at Risk for Cancer due to Family History

Wood M.E. · Flynn B.S. · Stockdale A.
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Abstract

Background: Risk stratification based on family history is a feature of screening guidelines for a number of cancers and referral guidelines for genetic counseling/testing for cancer risk. Aims: Our aim was to describe primary care physician perceptions of their role in managing cancer risk based on family history. Methods: Structured interviews were conducted by a medical anthropologist with primary care physicians in 3 settings in 2 north-eastern states. Transcripts were systematically analyzed by a research team to identify major themes expressed by participants. Results: Forty interviews were conducted from May 2003 through May 2006. Physicians provided a diversity of views on roles in management of cancer risk based on family history, management practices and patient responses to risk information. They also provided a wide range of perspectives on criteria used for referral to specialists, types of specialists referred to and expected management roles for referred patients. Conclusion: Some primary care physicians appeared to make effective use of family history information for cancer risk management, but many in this sample did not. Increased focus on efficient assessment tools based on recognized guidelines, accessible guides to management options, and patient education and decision aids may be useful directions to facilitate broader use of family history information for cancer risk management.



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References

  1. Ziogas A, Horick NK, Kinney AY, Lowery JT, Domchek SM, Isaacs C, Griffin CA, Moorman PG, Edwards KL, Hill DA, Berg JS, Tomlinson GE, Anton-Culver H, Strong LC, Kasten CH, Finkelstein DM, Plon SE: Clinically relevant changes in family history of cancer over time. JAMA 2011;306:172-178.
  2. O'Neill SM, Rubinstein WS, Wang C, Yoon PW, Acheson LS, Rothrock N, Starzyk EJ, Beaumont JL, Galliher JM, Ruffin MT 4th; Family Healthware Impact Trial group: Familial risk for common diseases in primary care: the Family Healthware Impact Trial. Am J Prev Med 2009;36:506-514.
  3. Scheuner MT, Wang SJ, Raffel LJ, Larabell SK, Rotter JI: Family history: a comprehensive genetic risk assessment method for the chronic conditions of adulthood. Am J Med Genet 1997;71:315-324.
  4. Yoon PW, Scheuner MT, Peterson-Oehlke KL, Gwinn M, Faucett A, Khoury MJ: Can family history be used as a tool for public health and preventive medicine? Genet Med 2002;4:304-310.
  5. Rich EC, Burke W, Heaton CJ, Haga S, Pinsky L, Short MP, Acheson L: Reconsidering the family history in primary care. J Gen Intern Med 2004;19:273-280.
  6. U.S. Preventive Services Task Force: Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer susceptibility: recommendation statement. Ann Intern Med 2005;143:355-361.
  7. Catalona WJ, Antenor JA, Roehl KA, Moul JW: Screening for prostate cancer in high risk populations. J Urol 2002;168:1980-1983.

    External Resources

  8. Cairns S, Scholefield JH: Guidelines for colorectal cancer screening in high risk groups. Gut 2002;51(suppl 5):V1-V2.
  9. Pharoah PD, Ponder BA: The genetics of ovarian cancer. Best Pract Res Clin Obstet Gynaecol 2002;16:449-468.
  10. Hampel H, Sweet K, Westman JA, Offit K, Eng C: Referral for cancer genetics consultation: a review and compilation of risk assessment criteria. J Med Genet 2004;41:81-91.
  11. Ready K, Arun B: Clinical assessment of breast cancer risk based on family history. J Natl Compr Canc Netw 2010;8:1148-1155.

    External Resources

  12. Acton RT, Burst NM, Casebeer L, Ferguson SM, Greene P, Laird BL, Leviton L: Knowledge, attitudes, and behaviors of Alabama's primary care physicians regarding cancer genetics. Acad Med 2000;75:850-852.
  13. Tyler CV Jr, Snyder CW: Cancer risk assessment: examining the family physician's role. J Am Board Fam Med 2006;19:468-477.
  14. Flynn BS, Wood ME, Ashikaga T, Stockdale A, Dana GS, Naud S: Primary care physicians' use of family history for cancer risk assessment. BMC Fam Pract 2010;11:45.
  15. Watson EK, 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;16:420-425.
  16. Desai MM, Bruce ML, Desai RA, Druss BG: Validity of self-reported cancer history: a comparison of health interview data and cancer registry records. Am J Epidemiol 2001;153:299-306.
  17. Qureshi N, Wilson B, Santaguida P, Carroll J, Allanson J, Culebro CR, Brouwers M, Raina P: Collection and use of cancer family history in primary care. Evid Rep Technol Assess (Full Rep) 2007;1-84.

    External Resources

  18. Wood ME, Stockdale A, Flynn BS: Interviews with primary care physicians regarding taking and interpreting the cancer family history. Fam Pract 2008;25:334-340.
  19. Miles MB, Hubermann AM: Qualitative Data Analysis, ed 2. Thousand Oaks, Sage Publications, 1994.
  20. Berg AO, Baird MA, Botkin JR, Driscoll DA, Fishman PA, Guarino PD, Hiatt RA, Jarvik GP, Millon-Underwood S, Morgan TM, Mulvihill JJ, Pollin TI, Schimmel SR, Stefanek ME, Vollmer WM, Williams JK: National Institutes of Health State-of-the-Science Conference Statement: Family History and Improving Health. Ann Intern Med 2009;151:872-877.
  21. Hofman KJ, Tambor ES, Chase GA, Geller G, Faden RR, Holtzman NA: Physicians' knowledge of genetics and genetic tests. Acad Med 1993;68:625-632.
  22. Sifri R, Myers R, Hyslop T, Turner B, Cocroft J, Rothermel T, Grana J, Schlackman N: Use of cancer susceptibility testing among primary care physicians. Clin Genet 2003;64:355-360.
  23. Suther S, Goodson P: Barriers to the provision of genetic services by primary care physicians: a systematic review of the literature. Genet Med 2003;5:70-76.
  24. Gramling R, Nash J, Siren K, Eaton C, Culpepper L: Family physician self-efficacy with screening for inherited cancer risk. Ann Fam Med 2004;2:130-132.


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