title: Genetic testing in a gynaecological oncology care in developing countries-knowledge, attitudes and perception of Nepalese clinicians.
abstract: BACKGROUND
  Genetic testing for an inherited susceptibility to cancer is an emerging technology in medical practice. Little information is currently available about physicians' attitudes towards these tests in developing countries.
  
  
  METHODS
  We conducted an email survey of Nepalese physicians practicing in academic and non-academic settings in Nepal, regarding knowledge, attitudes and perception towards genetic testing for gynaecologic cancer.
  
  
  RESULTS
  Responses were received from 251 of 387 practitioners (65%). Only 46% of all respondents felt prepared to answer patients' questions about genetic testing for gynaecologic cancer, despite 80% reporting that patients had asked questions about genetic testing, and 55% being asked more than 5 times in the past year. 42% reported more than 10 of their patients having had genetic testing for cancer, the majority forBRCA1/2. Access (40%), cost (37%) and lack of physicians' information (24%) were cited as the main barriers to testing. The most commonly identified concerns regarding genetic testing were the potential for increased patient anxiety, misinterpretation of results by patients, and maintaining confidentiality of results (64%, 47% and 38% of respondents respectively).
  
  
  CONCLUSIONS
  This study shows the gap among the health care providers in developing countries and the available modern scientific tools and skills in regard to the benefits of genetic testing for gynaecological cancers in a developing nation. These findings indicate the need for the introduction of further genetic counselling education and support into gynaecological care in Nepal.
authors.affiliation: Department of Obstetrics & Gynaecology, B P Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Hanoon P
authors.initials: HP
authors.lastname: Pokharel
authors.affiliation: Royal Hospital for Women, Randwick, Australia ; School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
authors.forename: Neville F
authors.initials: NF
authors.lastname: Hacker
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Sydney, Australia ; Prince of Wales Hospital, Randwick, Australia.
authors.forename: Lesley
authors.initials: L
authors.lastname: Andrews
keywords: Genetic testing; Hereditary gynaecological cancer; Nepal; Physician attitudes; Physician survey