Reporting BRCA test results to primary care physicians

Purpose: The main purpose of this study was to determine if comprehension o f the cancer risk information presented in a hypothetical report for BRCA1/ 2 gene analyses was influenced by the format in which the information was p resented. A secondary objective was to determine physician characteristics that might influence comprehension of the report. Methods: A survey was con ducted in which a case vignette describing a young woman at high risk for c arrying a BRCA mutation was presented. Survey participants, all primary car e practitioners, were asked to interpret a laboratory report that provided the patient's BRCA1/2 test result and accompanying data about the cumulativ e risk and incidence rates of breast cancer for BRCA1/2 mutation carriers a nd the general population. These data were presented in the report in eithe r a tabular or a graphic format. The main outcome was measured by the respo nses to four questions that addressed the probabilistic cancer risk informa tion. Physician predictor variables included medical specialty, practice se tting, years in practice, continuing medical education in genetics, and kno wledge of cumulative risk. Results: Knowledge of cumulative risk was the on ly physician variable that influenced comprehension of the cancer risk info rmation (OR = 31.9; P < 0.001). After adjusting for this variable, the grap hic format tended to perform better than the tabular format in conveying br east cancer risk information (OR = 3.1; P = 0.102). Conclusions: Many physi cians may be unprepared to interpret genetic risk information, due to lack of understanding of basic epidemiologic terms used to express the risk of d isease.