Colorado family physicians' knowledge of hereditary breast cancer and related practice

The objective of this study was to describe Colorado family physicians' (FPs') knowledge of hereditary breast cancer and related practice behaviors.

A survey was mailed to 400 practicing FPs randomly sampled from the board-certified members of the Colorado Academy of Family physicians.

Overall, knowledge of hereditary breast cancer was inadequate. Less than half of the respondents knew that BRCA mutations account for 0-10% of all breast cancers; 38% knew the lifetime risk for non-carriers, and 17% responded that a known carrier would have a lifetime breast cancer risk of 50%. Just 45% knew that a BRCA1 mutation could pass from father to daughter. Similarly, only half reported an increased ovarian cancer risk for BRCA1 carriers, and an increased risk for male breast cancer for BRCA2 carriers. All respondents reported that taking a family cancer history was part of their regular clinical practices. The majority reported having referred no patient for cancer genetic counseling or testing within the prior year, with only two reporting having ordered BRCA1 or BRCA2 testing within the year. There was no significant sociodemographic or knowledge difference between the physicians who reported referring patients and the others (p > 0.05). There was interest in learning more about hereditary breast cancer, with rural physicians requesting Internet and teleconference courses.

As cancer genetics emerges into the primary care arena. FPs recognize their knowledge deficit in this area. Future cancer genetic outreach for primary care providers statewide is necessary and would be welcomed, and may require a variety of educational and consultative approaches, depending on geographic location of practice.