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. 2017 Mar;32(3):315-324.
doi: 10.1007/s11606-016-3943-4. Epub 2016 Dec 19.

Primary care providers' cancer genetic testing-related knowledge, attitudes, and communication behaviors: A systematic review and research agenda

Jada G Hamilton  1 , Ekland Abdiwahab  2 , Heather M Edwards  3 , Min-Lin Fang  4 , Andrew Jdayani  5 , Erica S Breslau  6
Affiliations

Primary care providers' cancer genetic testing-related knowledge, attitudes, and communication behaviors: A systematic review and research agenda

Jada G Hamilton et al. J Gen Intern Med. 2017 Mar.

Abstract

Background: Primary care providers (PCPs) can play a critical role in helping patients receive the preventive health benefits of cancer genetic risk information. Thus, the objective of this systematic review was to identify studies of US PCPs' knowledge, attitudes, and communication-related behaviors regarding genetic tests that could inform risk-stratification approaches for breast, colorectal, and prostate cancer screening in order to describe current findings and research gaps.

Methods: We conducted a systematic search of six electronic databases to identify peer-reviewed empirical articles relating to US PCPs and genetic testing for breast, colorectal, or prostate cancer published in English from 2008 to 2016. We reviewed these data and used narrative synthesis methods to integrate findings into a descriptive summary and identify research needs.

Results: We identified 27 relevant articles. Most focused on genetic testing for breast cancer (23/27) and colorectal cancer risk (12/27); only one study examined testing for prostate cancer risk. Most articles addressed descriptive research questions (24/27). Many studies (24/27) documented PCPs' knowledge, often concluding that providers' knowledge was incomplete. Studies commonly (11/27) examined PCPs' attitudes. Across studies, PCPs expressed some concerns about ethical, legal, and social implications of testing. Attitudes about the utility of clinical genetic testing, including for targeted cancer screening, were generally favorable; PCPs were more skeptical of direct-to-consumer testing. Relatively fewer studies (9/27) examined PCPs' communication practices regarding cancer genetic testing.

Discussion: This review indicates a need for investigators to move beyond descriptive research questions related to PCPs' knowledge and attitudes about cancer genetic testing. Research is needed to address important gaps regarding the development, testing, and implementation of innovative interventions and educational programs that can improve PCPs' genetic testing knowledge, assuage concerns about the appropriateness of cancer genetic testing, and promote open and effective patient-provider communication about genetic risk and genetic testing.

Keywords: cancer; communication; genetic testing; health beliefs; knowledge; primary care.

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Conflict of interest statement

The authors declare that they do not have a conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram describing the literature search and record review process for the present study. *PubMed was searched on September 5, 2016, using MeSH terms and title/abstract search; †EMBASE was searched on August 3, 2016, using a combination of EMTREE and title/abstract search; ‡Web of Science and Cochrane Library were searched on August 3, 2016, using keyword search; §PsycINFO was searched on August 13, 2016, using keyword search; ǁCINAHL was searched on August 18, 2016, using a combination of CINAHL headings and keyword search
See this image and copyright information in PMC

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