Clinicians' views on introducing epidermal growth factor receptor testing in New Zealand.
OBJECTIVE
Inequities exist in the outcomes of patients diagnosed with lung cancer in New Zealand, with Māori (the indigenous population) having significantly higher diagnosis rates and poorer survival. We investigated the feasibility of introducing epidermal growth factor receptor (EGFR) testing into New Zealand as one step to address these inequities.


METHODS
An anonymous electronic questionnaire was distributed to clinicians from specialties involved in lung cancer management. Questions were grouped around topics including challenges in lung cancer management, EGFR testing, targeted therapy, costs and interest in the development of a national lung tissue bank.


RESULTS
In total, 61 clinicians responded and noted that few of their non-small-cell lung cancer patients were tested for EGFR mutations. Most clinicians (84%) would prefer a centralized testing service and 95% would use an overseas laboratory if publicly funded; however 62% did not know or had no preference for test procedures. Under half (46%) had used tyrosine kinase inhibitors with only a small number of patients and 79% supported the development of a lung tissue bank.


CONCLUSIONS
While most respondents had little experience with EGFR testing, clinicians supported its introduction into New Zealand. However, a number of potential issues, including cost, laboratory expertise and the need for improved access to first-line targeted therapies that could be used if tests were mutation positive were also identified. Respondents identified potential cultural sensitivities related to sending tissue samples abroad for genetic tests that would necessitate clinicians discussing this option with individual patients.
Research Centre for Māori Health and Development, Massey University, Palmerston North, New Zealand. l.batten@massey.ac.nz
Lesley S
LS
Batten
Helen S
HS
Winter
Claire L
CL
Hardie
Maureen A
MA
Holdaway
D001291:Attitude of Health Personnel; D002289:Carcinoma, Non-Small-Cell Lung / Q000201:enzymology / Q000235:genetics*; D004252:DNA Mutational Analysis / Q000379:methods / Q000706:statistics & numerical data; D066246:ErbB Receptors / Q000235:genetics* / Q000378:metabolism; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008175:Lung Neoplasms / Q000201:enzymology / Q000235:genetics*; D008297:Male; D009520:New Zealand; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D015996:Survival Rate
D066246:ErbB Receptors