title: Knowledge of genetic testing for hereditary kidney cancer in Canada is lacking: The results of the Canadian national hereditary kidney cancer needs assessment survey.
abstract: BACKGROUND
  Treatment of hereditary renal cell carcinoma (HRCC) requires a multidisciplinary approach that may involve medical oncologists, geneticists, genetic counsellors, and urologists. The objective of our survey was to obtain current and representative information about the use and perceived importance of genetic testing for HRCC in Canada.
  
  
  METHODS
  A self-administered web-based survey was provided to Canadian medical oncologists, geneticists, genetic counsellors, and urologists in collaboration with their respective associations. The survey was created through an iterative process in consultation with the Kidney Cancer Research Network of Canada and contained both quantitative and qualitative components. The survey was designed to be exploratory and results were compared across regions.
  
  
  RESULTS
  The overall response was low (6.6%). Of the respondents, 42%, 33%, 19%, 5% were genetic counsellors, urologists, medical oncologists and medical geneticists, respectively. Of the respondents, 62.7% described their practice as academic, and 37.3% described it as non-academic. Non-academic respondents tended to refer for genetic counselling less frequently than academic (48.6% vs. 67.2%). Most respondents believed that genetic testing for HRCC was available (82.8%), although 47.7% did not know which tests were available. This observation was consistent across provinces. Testing for Von Hippel-Lindau syndrome was given the highest priority among respondents. Limited provider knowledge, clinical guidelines, institutional funding, access, and poor coordination between disciplines were cited as barriers to testing.
  
  
  CONCLUSIONS
  There is a need to increase provider knowledge of genetic testing for HRCC. These findings support the development of practice guidelines and national strategies to improve coordination of specialists and access to genetics services. Limitations of the present study include low survey response which did not allow for inferential analysis by geographic region or respondent specialty.
authors.affiliation: Division of Urology, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON;
authors.forename: Philippe D
authors.initials: PD
authors.lastname: Violette
authors.affiliation: Molecular Diagnostics, Department of Pathology, University Health Network, Toronto, ON;
authors.forename: Suzanne
authors.initials: S
authors.lastname: Kamel-Reid
authors.affiliation: Eastern Ontario Regional Genetics Program, Children's Hospital of Eastern Ontario and the University of Ottawa, Ottawa, ON;
authors.forename: Gail E
authors.initials: GE
authors.lastname: Graham
authors.affiliation: Division of Medical Oncology, The Ottawa Hospital Cancer Centre and the University of Ottawa, Ottawa, ON;
authors.forename: M Neil
authors.initials: MN
authors.lastname: Reaume
authors.affiliation: Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, ON;
authors.forename: Michael A
authors.initials: MA
authors.lastname: Jewett
authors.affiliation: Department of Molecular Genetics, University Health Network, Toronto, ON;
authors.forename: Melanie
authors.initials: M
authors.lastname: Care
authors.affiliation: Kidney Cancer Research Network of Canada, Toronto, ON;
authors.forename: Joan
authors.initials: J
authors.lastname: Basiuk
authors.affiliation: Division of Urology, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON; ; Division of Surgical Oncology, Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Pautler