CONTEXT: Challenges to the identification of hereditary cancer in primary care may be more pronounced in rural Appalachia, a medically underserved region. PURPOSE: To examine primary care physicians' identification of hereditary cancers. METHODS: A cross-sectional survey was mailed to family physicians in the midwestern and southeastern United States, stratified by rural/non-rural and Appalachian/non-Appalachian practice location (n = 176). Identification of hereditary breast-ovarian cancer (BRCA1/2), hereditary non-polyposis colon cancer (HNPCC), and other hereditary cancers was assessed. FINDINGS: Less than half of physicians (45%) reported having patients with cancer genetic testing. Most (70%) correctly identified the BRCA1/2-relevant scenario; 49% correctly identified the HNPCC-relevant scenario. Factor analysis of psychosocial variables revealed 2 factors: Confidence (knowledge, comfort, confidence) and importance (responsible, important, effective, need) of identifying hereditary cancer. Greater confidence was associated with use of 3 generation pedigree in taking family history. Greater knowledge and access to genetic services were associated with use of genetic testing. More recent graduation year, greater knowledge, and greater confidence were associated with identifying the BRCA1/2-relevant scenario. Greater knowledge and confidence were associated with identifying the HNPCC-relevant scenario. CONCLUSIONS: Though rural Appalachian physicians do not differ in ability to identify high risk individuals, access barriers may exist for genetic testing. Interventions are needed to boost physician confidence in identifying hereditary cancer and to improve availability and awareness of availability of genetic services.
CONTEXT: Challenges to the identification of hereditary cancer in primary care may be more pronounced in rural Appalachia, a medically underserved region. PURPOSE: To examine primary care physicians' identification of hereditary cancers. METHODS: A cross-sectional survey was mailed to family physicians in the midwestern and southeastern United States, stratified by rural/non-rural and Appalachian/non-Appalachian practice location (n = 176). Identification of hereditary breast-ovarian cancer (BRCA1/2), hereditary non-polyposis colon cancer (HNPCC), and other hereditary cancers was assessed. FINDINGS: Less than half of physicians (45%) reported having patients with cancer genetic testing. Most (70%) correctly identified the BRCA1/2-relevant scenario; 49% correctly identified the HNPCC-relevant scenario. Factor analysis of psychosocial variables revealed 2 factors: Confidence (knowledge, comfort, confidence) and importance (responsible, important, effective, need) of identifying hereditary cancer. Greater confidence was associated with use of 3 generation pedigree in taking family history. Greater knowledge and access to genetic services were associated with use of genetic testing. More recent graduation year, greater knowledge, and greater confidence were associated with identifying the BRCA1/2-relevant scenario. Greater knowledge and confidence were associated with identifying the HNPCC-relevant scenario. CONCLUSIONS: Though rural Appalachian physicians do not differ in ability to identify high risk individuals, access barriers may exist for genetic testing. Interventions are needed to boost physician confidence in identifying hereditary cancer and to improve availability and awareness of availability of genetic services.
Authors: Eugene C Rich; Wylie Burke; Caryl J Heaton; Susanne Haga; Linda Pinsky; M Priscilla Short; Louise Acheson Journal: J Gen Intern Med Date: 2004-03 Impact factor: 5.128
Authors: Jada G Hamilton; Ekland Abdiwahab; Heather M Edwards; Min-Lin Fang; Andrew Jdayani; Erica S Breslau Journal: J Gen Intern Med Date: 2016-12-19 Impact factor: 5.128
Authors: Daniel Chavez-Yenter; Melody S Goodman; Yuyu Chen; Xiangying Chu; Richard L Bradshaw; Rachelle Lorenz Chambers; Priscilla A Chan; Brianne M Daly; Michael Flynn; Amanda Gammon; Rachel Hess; Cecelia Kessler; Wendy K Kohlmann; Devin M Mann; Rachel Monahan; Sara Peel; Kensaku Kawamoto; Guilherme Del Fiol; Meenakshi Sigireddi; Saundra S Buys; Ophira Ginsburg; Kimberly A Kaphingst Journal: JAMA Netw Open Date: 2022-10-03
Authors: Jennifer A Mallow; Laurie A Theeke; Patricia Crawford; Elizabeth Prendergast; Chuck Conner; Tony Richards; Barbara McKown; Donna Bush; Donald Reed; Meagan E Stabler; Jianjun Zhang; Geri Dino; Taura L Barr Journal: Online J Rural Nurs Health Care Date: 2016
Authors: Kimberly A Kaphingst; Wendy Kohlmann; Rachelle Lorenz Chambers; Melody S Goodman; Richard Bradshaw; Priscilla A Chan; Daniel Chavez-Yenter; Sarah V Colonna; Whitney F Espinel; Jessica N Everett; Amanda Gammon; Eric R Goldberg; Javier Gonzalez; Kelsi J Hagerty; Rachel Hess; Kelsey Kehoe; Cecilia Kessler; Kadyn E Kimball; Shane Loomis; Tiffany R Martinez; Rachel Monahan; Joshua D Schiffman; Dani Temares; Katie Tobik; David W Wetter; Devin M Mann; Kensaku Kawamoto; Guilherme Del Fiol; Saundra S Buys; Ophira Ginsburg Journal: BMC Health Serv Res Date: 2021-06-02 Impact factor: 2.655