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. 2021 Aug;16(4):389-395.
doi: 10.1159/000511136. Epub 2020 Nov 4.

Survey on Physicians' Knowledge and Training Needs in Genetic Counseling in Germany

Julia Dick  1 , Viktoria Aue  1 , Simone Wesselmann  2 , Anne Brédart  3   4 , Sylvie Dolbeault  3   5 , Peter Devilee  6 , Dominique Stoppa-Lyonnet  7 , Rita K Schmutzler  1 , Kerstin Rhiem  1
Affiliations

Survey on Physicians' Knowledge and Training Needs in Genetic Counseling in Germany

Julia Dick et al. Breast Care (Basel). 2021 Aug.

Abstract

Background: In recent years, germline testing of women with a risk of developing breast and ovarian cancer has increased rapidly. This is due to lower costs for new high-throughput sequencing technologies and the manifold preventive and therapeutic options for germline mutation carriers. The growing demand for genetic counseling meets a shortfall of counselors and illustrates the need to involve the treating clinicians in the genetic testing process. This survey was undertaken to assess their state of knowledge and training needs in the field of genetic counseling and testing.

Methods: A cross-sectional survey within the European Bridges Study (Breast Cancer Risk after Diagnostic Gene Sequencing) was conducted among physician members (n = 111) of the German Cancer Society who were primarily gynecologists. It was designed to examine their experience in genetic counseling and testing.

Results: Overall, the study revealed a need for training in risk communication and clinical recommendations for persons at risk. One-third of respondents communicated only relative disease risks (31.5%) instead of absolute disease risks in manageable time spans. Moreover, almost one-third of the respondents (31.2%) communicated bilateral and contralateral risk-reducing mastectomy as an option for healthy women and unilateral-diseased breast cancer patients without mutations in high-risk genes (e.g. BRCA1 or BRCA2). Most respondents expressed training needs in the field of risk assessment models, the clinical interpretation of genetic test results, and the decision-making process.

Conclusion: The survey demonstrates a gap of genetic and risk literacy in a relevant proportion of physicians and the need for appropriate training concepts.

Keywords: BRCA1/BRCA2 mutations; Genetic counseling; Genetic testing; Hereditary breast cancer.

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Conflict of interest statement

The authors declare there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Percentages of physicians considering risk factors to be important or very important on a 5-point Likert Scale (unimportant, less important, neither unimportant nor important, important, very important) for estimating breast cancer risk (n = 90).
Fig. 2
Fig. 2
Percentages of physicians using cancer risk prediction models.
Fig. 3
Fig. 3
Training needs that participants either agreed or strongly agreed with (n = 74).
See this image and copyright information in PMC

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