title: Awareness and utilization of BRCA1/2 testing among U.S. primary care physicians.
abstract: BACKGROUND
  Testing for mutations in the breast and ovarian cancer susceptibility genes BRCA1 and BRCA2 (BRCA) has been commercially available since 1996.
  
  
  OBJECTIVE
  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.
authors.affiliation: CDC, Atlanta, Georgia 30333, USA. cbellcross@cdc.gov
authors.forename: Cecelia A
authors.initials: CA
authors.lastname: Bellcross
authors.forename: Katherine
authors.initials: K
authors.lastname: Kolor
authors.forename: Katrina A B
authors.initials: KA
authors.lastname: Goddard
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Coates
authors.forename: Michele
authors.initials: M
authors.lastname: Reyes
authors.forename: Muin J
authors.initials: MJ
authors.lastname: Khoury
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics; D003625:Data Collection; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010051:Ovarian Neoplasms / Q000235:genetics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data; D014481:United States