July 25, 2011

Female Cancer Patients Aren’t Properly Counseled

(Ivanhoe Newswire) "“ Discovered through a new study, many doctors reported in a questionnaire that they do not appropriately offer breast and ovarian cancer counseling and testing services to their female patients. The researchers show that efforts are needed to encourage these services for women at high-risk of breast and ovarian cancer, and discourage them for average-risk women.

Little is known about whether physicians are adhering to recommendations related to genetic counseling and testing for women at average and high risk of ovarian cancer.

It's important for woman with mutations in the BRCA1 or BRCA2 gene, since they have a substantially increased risk of developing breast and ovarian cancer, but there are medical treatments that can dramatically decrease their risk. Therefore it's essential that genetic counseling and testing are recommended for women at high risk of developing breast or ovarian cancer because of a personal or family history indicative of a BRCA 1 or 2 mutations. Importantly though, they are not recommended for women at average risk because the harms of treatment outweigh the benefits.

Researchers surveyed 3,200 U.S. family physicians, general internists, and obstetrician-gynecologists; they were asked about the services they would provide to women at annual exams, including how frequently they would refer women to genetic counseling or offer BRCA 1 or 2 testing.

There were 1,878 physicians that responded to the survey. Less than half of the physicians reported that they would recommend referral for genetic counseling or testing, for high-risk women. Twenty-nine percent reported that they would sometimes or always refer average-risk women for genetic counseling and testing.

 "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," Katrina Trivers, Ph.D, MSPH, of the Centers for Disease Control and Prevention in Atlanta, was quoted saying,

When high-risk women do not receive these services, they could miss out on important interventions that can decrease their risk. But, when physicians refer average-risk women for counseling and testing, it's an inefficient use of resources that is associated with a small clinical benefit. The researchers found that physicians reported that they were more likely to follow guideline recommendations when they were able to accurately estimate their patients' risks of ovarian cancer.

SOURCE: CANCER, the online edition, July 22, 2011