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Cancer Genetic Risk Assessment and Referral Patterns in Primary Care

机译:初级保健中的癌症遗传风险评估和转诊模式

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摘要

Purpose: 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. Conclusion: 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.
机译:目的:本研究旨在描述初级保健提供者(PCP)中的癌症风险评估实践。方法:将电子调查发送给与单个保险公司有关联的PCP。描述了与癌症遗传风险评估和测试活动相关的人口统计学和实践特征。由可能性比测试支持的潜在类别分析用于根据人口统计学和实践特征,针对参与遗传风险评估和推荐活动的水平来定义PCP配置文件。结果:860位医师对调查做出了回应(39%的家庭医生,29%的内科药物,22%的妇产科(OB / GYN),10%的其他医生)。大多数受访者(83%)报告说,他们定期评估遗传性癌症风险。但是,只有33%的受访者表示他们接受了完整的第三代血统书进行风险评估。妇产科/妇产科专业,女性和医师获得遗传咨询师的机会是转诊至癌症遗传学专家的独立预测因素。根据转诊实践和遗传学评估的参与程度,确定了五氯苯酚的三种概况。结论:可以确定与癌症遗传风险评估和测试的参与程度不同相关的医生特征。这些配置文件最终可用于定位决策支持工具和服务。

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