title: Cancer genetic risk assessment and referral patterns in primary care.
abstract: OBJECTIVE
  This study was undertaken to describe cancer risk assessment practices among primary care providers (PCPs).
  
  
  METHODS
  An electronic survey was sent to PCPs affiliated with a single insurance carrier. Demographic and practice characteristics associated with cancer genetic risk assessment and testing activities were described. Latent class analysis supported by likelihood ratio tests was used to define PCP profiles with respect to the level of engagement in genetic risk assessment and referral activity based on demographic and practice characteristics.
  
  
  RESULTS
  860 physicians responded to the survey (39% family practice, 29% internal medicine, 22% obstetrics/gynecology (OB/GYN), 10% other). Most respondents (83%) reported that they routinely assess hereditary cancer risk; however, only 33% reported that they take a full, three-generation pedigree for risk assessment. OB/GYN specialty, female gender, and physician access to a genetic counselor were independent predictors of referral to cancer genetics specialists. Three profiles of PCPs, based upon referral practice and extent of involvement in genetics evaluation, were defined.
  
  
  CONCLUSIONS
  Profiles of physician characteristics associated with varying levels of engagement with cancer genetic risk assessment and testing can be identified. These profiles may ultimately be useful in targeting decision support tools and services.
authors.affiliation: Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
authors.forename: Hetal S
authors.initials: HS
authors.lastname: Vig
authors.forename: Joanne
authors.initials: J
authors.lastname: Armstrong
authors.forename: Brian L
authors.initials: BL
authors.lastname: Egleston
authors.forename: Carla
authors.initials: C
authors.lastname: Mazar
authors.forename: Michele
authors.initials: M
authors.lastname: Toscano
authors.forename: Angela R
authors.initials: AR
authors.lastname: Bradbury
authors.forename: Mary B
authors.initials: MB
authors.lastname: Daly
authors.forename: Neal J
authors.initials: NJ
authors.lastname: Meropol
mesh_terms: D000328:Adult; D000368:Aged; D003625:Data Collection; D005260:Female; D005820:Genetic Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000235:genetics*; D010375:Pedigree; D011320:Primary Health Care; D012017:Referral and Consultation; D012737:Sex Factors