Awareness and Utilization of BRCA1/2 Testing Among US Primary Care Physicians
Awareness and Utilization of BRCA1/2 Testing Among US Primary Care Physicians
复制标题
DOI：
10.1016/j.amepre.2010.09.027
复制
发表时间：
2011-01-01
影响因子：
5.5
通讯作者：
Khoury, Muin J.
中科院分区：
文献类型：
--
作者：
Bellcross, Cecelia A.;Kolor, Katherine;Khoury, Muin J.
背景：自1996年以来，乳腺癌和卵巢癌易感基因BRCA1和BRCA2 （BRCA）的突变检测已经商业化。目的：本研究旨在确定美国初级保健医生对BRCA检测的认识和使用水平以及2005年美国预防服务工作组（USPSTF）的建议。方法：2009年，对参与2007年DocStyles全国调查的1500名医生（515名家庭医生、485名内科医生、250名儿科医生和250名妇产科医生）的数据进行分析。结果：总体而言，87%的医生知道BRCA检测，25%的医生报告在过去一年中至少为一名患者安排了检测。在执业10年以上的妇产科医生中，预约检查最为普遍，患者更富裕。医生被要求根据USPSTF指南从7种不同的临床场景中选择BRCA检测的适应症，这些临床场景代表了增加(4)或低风险(3)的情况。在订购医生（儿科医生除外）中，45%的人选择至少一种低风险情景作为BRCA检测的指征。只有19%的人正确选择了所有风险增加的场景，而没有选择任何低风险的场景。结论：绝大多数初级保健医生都知道BRCA检测，许多人报告在过去一年内至少做过一次检测。然而，少数人似乎始终认为由USPSTF确定的家族史模式是BRCA评估的适当适应症。这些结果表明，有必要提高供应商对现有推荐的了解，特别是在这个BRCA直接面向消费者营销的时代。[J] .中华预防医学杂志，2011;40(1):61-66
Background: Testing for mutations in the breast and ovarian cancer susceptibility genes BRCA1 and BRCA2 (BRCA) has been commercially available since 1996.Purpose: This study sought to determine, among U. S. primary care physicians, the level of awareness and utilization of BRCA testing and the 2005 U. S. Preventive Services Task Force (USPSTF) recommendations.Methods: In 2009, data were analyzed on 1500 physician respondents to the 2007 DocStyles national survey (515 family practitioners, 485 internists, 250 pediatricians, and 250 obstetricians/gynecologists).Results: Overall, 87% of physicians were aware of BRCA testing, and 25% reported having ordered testing for at least one patient in the past year. Ordering tests was most prevalent among obstetricians/gynecologists in practice for more than 10 years, with more affluent patients. Physicians were asked to select indications for BRCA testing from seven different clinical scenarios representing increased (4) or low-risk (3) situations consistent with the USPSTF guidelines. Among ordering physicians (pediatricians excluded), 45% chose at least one low-risk scenario as an indication for BRCA testing. Only 19% correctly selected all of the increased-risk and none of the low-risk scenarios.Conclusions: A substantial majority of primary care physicians are aware of BRCA testing and many report having ordered at least one test within the past year. A minority, however, appear to consistently recognize the family history patterns identified by the USPSTF as appropriate indications for BRCA evaluation. These results suggest the need to improve providers' knowledge about existing recommendations-particularly in this era of increased BRCA direct-to-consumer marketing. (Am J Prev Med 2011; 40(1): 61-66) (C) 2011 American Journal of Preventive Medicine