Ovarian and breast cancer counseling and testing not offered according to guidelines in physician practices


Ovarian and breast cancer counseling and testing not offered according to guidelines in physician practices


A considerable number of doctors do not appear to offer ovarian and breast cancer counseling, as well as testing services to women at high risk, researchers from the CDC (Centers for Disease Control and Prevention) report in the journal Cancer.

Females with the BRCA1 or BRCA2 gene have a much higher chance of developing ovarian or breast cancer compared to other women. However, available medical treatment can considerably reduce their risk.

Current recommendations say that females with a high ovarian or breast cancer risk should be offered genetic counseling, but not women of average risk because the harms are greater than the benefits.

Whether or not doctors are following these recommendations was unclear before this study was carried out, the authors explained.

Katrina Trivers, PhD, MSPH, and team evaluated 3,200 general practitioners (primary care physicians, family physicians), general internists, and specialists (ob-gyns). They were all asked to complete a questionnaire in which they explained what services they offered to women at annual exams. Included among the questions was how often they would refer their patients to genetic counseling, or offer BRCA 1/BRCA2 testing.

62% (1,878 doctors) completed the survey. Only 41% of them said they would recommend referring their patient to genetic counseling or testing - something the guidelines recommend.

29% of them said they would always or sometimes refer average-risk women for genetic counseling or testing.

Dr. Trivers said:

"Despite the existence of evidence-based guidelines on referral for genetic counseling and testing for hereditary breast and ovarian cancer, many physicians report practices contrary to these recommendations."

The authors pointed out that women who miss out on these services and are at high risk of ovarian or breast cancer could be missing out on vital interventions that can significantly lower their risk. It is also an inefficient use of resources by 29% of doctors who refer average risk women to such services.

The researchers added that physicians told them that there was a greater chance they would follow the guidelines if they could precisely estimate a woman's cancer risk.

"Reported referral for genetic counseling or BRCA 1/2 testing among US physicians: A vignette-based study."

Katrina F. Trivers, Laura-Mae Baldwin, Jacqueline W. Miller, Barbara Matthews, C. Holly A. Andrilla, Denise M. Lishner, and Barbara A. Goff.

CANCER; Published Online: July 25, 2011 (DOI: 10.1002/cncr.26166).


Genetic Testing for Women at High Risk for Breast and Ovarian Cancers (Video Medical And Professional 2018).

Section Issues On Medicine: Women health