Attitudes of physicians regarding receiving and storing patients' genetic testing results for cancer susceptibility

In order to determine interest in and support for a genetic counseling prog ram for heritable cancers, a four-item questionnaire was sent to 700 physic ians in San Diego County likely to encounter patients with significant fami ly histories of cancer. Included in the questionnaire was an item requestin g information about physician attitudes and practices regarding their recor d keeping for patient results of genetic testing for cancer susceptibility. Ninety-two questionnaires were returned for a response rate of 13%. The lo w response rate introduces caution when interpreting the results, particula rly if the physicians most interested in the topic were the most likely to respond. In this light, of note was the marked variability found in the att itudes of respondents regarding where the results of patients' genetic test ing results should be placed in relation to the medical record. Whereas one group of physicians would place the testing results into the medical recor d, just as they would any laboratory test result, other physicians do not e ven want written notice of the results in order to maintain patient confide ntiality. Another group acknowledges the sensitivity of the information, bu t prefers to store genetic testing results separately, as they would result s of HIV testing or history of psychiatric treatment. Genetic testing for c ancer susceptibility is associated with patient concerns regarding confiden tiality of testing results and fears of the consequences of release of this information to insurance companies. While the small and possibly biased sa mple must be considered when interpreting the results, the lack of consiste ncy among physicians about where to store genetic testing results in terms of the patient medical record underscores the need for both a consensus sta tement and legal protection for both patient and physician. Variability in physician practices suggests that the process of obtaining informed consent for genetic testing should include a discussion with the patient about how the confidentiality of test results will be maintained.