Journal Mobile Options
Table of Contents
Vol. 17, No. 2, 2014
Issue release date: April 2014
Section title: Original Paper
Public Health Genomics 2014;17:76-83
(DOI:10.1159/000356938)

Impact of Academic Affiliation and Training on Knowledge of Hereditary Colorectal Cancer

Chan V. · Blazey W. · Tegay D. · Harper B. · Koehler S. · Laurent B. · Lipka S. · Cohn J. · Jung M.-K. · Krishnamachari B.
aDepartment of Medicine, bDepartment of Family Medicine, cAcademic Health Care Center, dDivision of Research, and eAcademic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, N.Y., and fDepartment of Medicine, Nassau University Medical Center, East Meadow, N.Y., USA

Do you have an account?

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger (new!)
  • Unrestricted printing, no saving restrictions for personal use
  • Reduced rates with a PPV account
read more

Direct: USD 38.00
Account: USD 26.50

Select

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restriction apply

Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Automatic perpetual access to all articles of the subscribed year(s)
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 6/14/2013
Accepted: 10/31/2013
Published online: 1/22/2014

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 4

ISSN: 1662-4246 (Print)
eISSN: 1662-8063 (Online)

For additional information: http://www.karger.com/PHG

Abstract

Background: Knowledge about hereditary colorectal cancer (CRC) can aid cancer screening and prevention in high-risk patients. Genetic testing, once conducted primarily at academic centers, is now routinely performed in a variety of clinics. Nonacademic physicians may not be aware of hereditary CRC standards of care. Methods: From August to November 2012, a survey was administered to predominantly primary care physicians evaluating academic center affiliation, past training in genetics and knowledge regarding hereditary CRC. Results: One hundred forty physicians completed the survey. Knowledge of hereditary CRC was neither associated with academic affiliation nor with training during medical school or residency, but with continuing medical education (CME) training. Those with CME training were more likely to know that screening could be enhanced for patients with a hereditary cancer risk (OR = 4.49, 95% CI = 1.40-14.38) and that an individual with hereditary CRC would have different screening recommendations (OR = 7.49, 95% CI = 1.37-40.81). Residency training and CME training were associated with more frequent hereditary risk assessment. Conclusion: Genetics training may be associated with physicians' knowledge and assessment of hereditary CRC. Training at the CME level in particular may be integral to the delivery of genetic services in clinical practice.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 6/14/2013
Accepted: 10/31/2013
Published online: 1/22/2014

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 4

ISSN: 1662-4246 (Print)
eISSN: 1662-8063 (Online)

For additional information: http://www.karger.com/PHG


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. American Cancer Society: Colorectal cancer facts & figures 2008-2010. Atlanta, American Cancer Society, 2008.
  2. Patel SG, Ahnen DJ: Familial colon cancer syndromes: an update of a rapidly evolving field. Curr Gastroenterol Rep 2012;14:428-438.
  3. Burn J, Mathers J, Bishop DT: Genetics, inheritance and strategies for prevention in populations at high risk of colorectal cancer (CRC). Recent Results Cancer Res 2013;191:157-183.
  4. Lynch HT, de la Chapelle A: Hereditary colorectal cancer. N Engl J Med 2003;348:919-932.
  5. Vasen HF, Möslein G, Alonso A, Aretz S, Bernstein I, Bertario L, Blanco I, Bulow S, Burn J, Capella G, Colas C, Engel C, Frayling I, Rahner N, Hes FJ, Hodgson S, Mecklin JP, Møller P, Myrhøj T, Nagengast FM, Parc Y, Ponz de Leon M, Renkonen-Sinisalo L, Sampson JR, Stormorken A, Tejpar S, Thomas HJ, Wijnen J, Lubinski J, Järvinen H, Claes E, Heinimann K, Karagiannis JA, Lindblom A, Dove-Edwin I, Müller H: Recommendations to improve identification of hereditary and familial colorectal cancer in Europe. Fam Cancer 2010;9:109-115.
  6. American Gastroenterological Association: American Gastroenterological Association medical position statement: hereditary colorectal cancer and genetic testing. Gastroenterology 2001;121:195-197.
  7. Moreira L, Balaguer F, Lindor N, de la Chapelle A, Hampel H, Aaltonen LA, Hopper JL, Le Marchand L, Gallinger S, Newcomb PA, Haile R, Thibodeau SN, Gunawardena S, Jenkins MA, Buchanan DD, Potter JD, Baron JA, Ahnen DJ, Moreno V, Andreu M, Ponz de Leon M, Rustgi AK, Castells A; EPICOLON Consortium: Identification of Lynch syndrome among patients with colorectal cancer. JAMA 2012;308:1555-1565.
  8. Win AK, Lindor NM, Young JP, Macrae FA, Young GP, Williamson E, Parry S, Goldblatt J, Lipton L, Winship I, Leggett B, Tucker KM, Giles GG, Buchanan DD, Clendenning M, Rosty C, Arnold J, Levine AJ, Haile RW, Gallinger S, Le Marchand L, Newcomb PA, Hopper JL, Jenkins MA: Risks of primary extracolonic cancers following colorectal cancer in Lynch syndrome. J Natl Cancer Inst 2012;104:1363-1372.
  9. Hampel H, Frankel WL, Martin E, Arnold M, Khanduja K, Kuebler P, Clendenning M, Sotamaa K, Prior T, Westman JA, Panescu J, Fix D, Lockman J, LaJeunesse J, Comeras I, de la Chapelle A: Feasibility of screening for Lynch syndrome among patients with colorectal cancer. J Clin Oncol 2008;26:5783-5788.
  10. Vasen HF, Boland CR: Progress in genetic testing, classification, and identification of Lynch syndrome. JAMA 2005;293:2028-2030.
  11. Hampel H, Frankel WL, Martin E, Arnold M, Khanduja K, Kuebler P, Nakagawa H, Sotamaa K, Prior TW, Westman J, Panescu J, Fix D, Lockman J, Comeras I, de la Chapelle A: Screening for the Lynch syndrome (hereditary nonpolyposis colorectal cancer). N Engl J Med 2005;352:1851-1860.
  12. Hadley DW, Jenkins JF, Dimond E, de Carvalho M, Kirsch I, Palmer CG: Colon cancer screening practices after genetic counseling and testing for hereditary nonpolyposis colorectal cancer. J Clin Oncol 2004;22:39-44.
  13. Halbert CH, Lynch H, Lynch J, Main D, Kucharski S, Rustgi AK, Lerman C: Colon cancer screening practices following genetic testing for hereditary nonpolyposis colon cancer (HNPCC) mutations. Arch Intern Med 2004;164:1881-1887.
  14. Strafford JC: Genetic testing for Lynch syndrome, an inherited cancer of the bowel, endometrium, and ovary. Rev Obstet Gynecol 2012;5:42-49.

    External Resources

  15. National Comprehensive Cancer Network: NCCN clinical practice guidelines in oncology: colorectal cancer screening, v.2.2012. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp (accessed February 1, 2013).
  16. Munck A, Gargouri L, Alberti C, Viala J, Peuchmaur M, Lenaerts C, Michaud L, Lamireau T, Mougenot JF, Dabadie A, Maurage C, Lachaux A, Scaillon M, Languepin J, Spyckerelle C, Meyer M, Olschwang S: Evaluation of guidelines for management of familial adenomatous polyposis in a multicenter pediatric cohort. J Pediatr Gastroenterol Nutr 2011;53:296-302.
  17. Mallinson EK, Newton KF, Bowen J, Lalloo F, Clancy T, Hill J, Evans DG: The impact of screening and genetic registration on mortality and colorectal cancer incidence in familial adenomatous polyposis. Gut 2010;59:1378-1382.
  18. Galiatsatos P, Foulkes WD: Familial adenomatous polyposis. Am J Gastroenterol 2006;101:385-398.
  19. Sieber OM, Segditsas S, Knudsen AL, Zhang J, Luz J, Rowan AJ, Spain SL, Thirlwell C, Howarth KM, Jaeger EE, Robinson J, Volikos E, Silver A, Kelly G, Aretz S, Frayling I, Hutter P, Dunlop M, Guenther T, Neale K, Phillips R, Heinimann K, Tomlinson IP: Disease severity and genetic pathways in attenuated familial adenomatous polyposis vary greatly but depend on the site of the germline mutation. Gut 2006;55:1440-1448.
  20. Theodoratou E, Campbell H, Tenesa A, Houlston R, Webb E, Lubbe S, Broderick P, Gallinger S, Croitoru EM, Jenkins MA, Win AK, Cleary SP, Koessler T, Pharoah PD, Küry S, Bézieau S, Buecher B, Ellis NA, Peterlongo P, Offit K, Aaltonen LA, Enholm S, Lindblom A, Zhou XL, Tomlinson IP, Moreno V, Blanco I, Capellà G, Barnetson R, Porteous ME, Dunlop MG, Farrington SM: A large-scale meta-analysis to refine colorectal cancer risk estimates associated with MUTYH variants. Br J Cancer 2010;103:1875-1884.
  21. Vig HS, Armstrong J, Egleston BL, Mazar C, Toscano M, Bradbury AR, Daly MB, Meropol NJ: Cancer genetic risk assessment and referral patterns in primary care. Genet Test Mol Biomarkers 2009;13:735-741.
  22. Acheson LS, Wiesner GL: Current and future applications of genetics in primary care medicine. Prim Care 2004;31:449-460, vii.
  23. Bennett RL: The family medical history. Prim Care 2004;31:479-495, vii-viii.
  24. Epplein M, Koon KP, Ramsey SD, Potter JD: Genetic services for familial cancer patients: a follow-up survey of National Cancer Institute Cancer Centers. J Clin Oncol 2005;23:4713-4718.
  25. Shroy P, Barrison A, Ling B, Wilson S, Geller A: Family history and colorectal cancer screening: a survey of physician knowledge and practice patterns. Am J Gastroenterol 2002;97:1031-1036.
  26. Wideroff L, Vadaparampil ST, Greene MH, Taplin S, Olson L, Freedman AN: Hereditary breast/ovarian and colorectal cancer genetics knowledge in a national sample of US physicians. J Med Genet 2005;42:749-755.
  27. Tyler CV Jr, Snyder CW: Cancer risk assessment: examining the family physician's role. J Am Board Fam Med 2006;19:468-477.
  28. Klitzman R, Chung W, Marder K, Shanmugham A, Chin LJ, Stark M, Leu CS, Appelbaum PS: Attitudes and practices among internists concerning genetic testing. J Genet Couns 2013;22:90-100.
  29. 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.
  30. Robson ME, Storm CD, Weitzel J, Wollins DS, Offit K; American Society of Clinical Oncology: American Society of Clinical Oncology policy statement update: genetic and genomic testing for cancer susceptibility. J Clin Oncol 2010;28:893-901.
  31. Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM; American College of Gastroenterology: American College of Gastroenterology guidelines for colorectal cancer screening 2009. Am J Gastroenterol 2009;104:739-750.
  32. Yabroff KR, Klabunde CN, Yuan G, McNeel TS, Brown ML, Casciotti D, Buckman DW, Taplin S: Are physicians' recommendations for colorectal cancer screening guideline-consistent? J Gen Intern Med 2011;26:177-184.
  33. Wideroff L, Vadaparampil ST, Greene MH, Taplin S, Olson L, Freedman AN: Hereditary breast/ovarian and colorectal cancer genetics knowledge in a national sample of US physicians. J Med Genet 2005;42:749-755.
  34. Ready K, Daniels M, Sun C, Peterson S, Northrup H, Lu K: Obstetrics/gynecology residents' knowledge of hereditary breast and ovarian cancer and Lynch syndrome. J Canc Educ 2010;25:401-404.
  35. Klabunde CN, Lanier D, Nadel MR, McLeod C, Yuan G, Vernon SW: Colorectal cancer screening by primary care physicians: recommendations and practices, 2006-2007. Am J Prev Med 2009;37:8-16.
  36. Klabunde CN, Frame PS, Meadow A, Jones E, Nadel M, Vernon SW: A national survey of primary care physicians' colorectal cancer screening recommendations and practices. Prev Med 2003;36:352-362.
  37. Salz T, Oeffinger KC, Lewis PR, Williams RL, Rhyne RL, Yeazel MW: Primary care providers' needs and preferences for information about colorectal cancer survivorship care. J Am Board Fam Med 2012;25:635-651.
  38. Klabunde CN, Ambs A, Keating NL, He Y, Doucette WR, Tisnado D, Clauser S, Kahn KL: The role of primary care physicians in cancer care. J Gen Intern Med 2009;24:1029-1036.
  39. Snyder CF, Earle CC, Herbert RJ, Neville BA, Blackford AL, Frick KD: Trends in follow-up and preventive care for colorectal cancer survivors. J Gen Intern Med 2008;23:254-259.