Developing a cancer genetics service in Wales: opinions of gynaecologists on the management of women at risk of familial ovarian cancer

In Wales, a cancer genetics service has been developing since 1998. Gynaeco logists play an integral role in the management of women with a family hist ory of ovarian cancer and we were interested in investigating referral prac tice and management for relatives of patients with ovarian cancer among gyn aecologists in Wales. In 1999, a postal questionnaire was sent to all gynae cologists. The response rate was 51%. The questionnaire contained structure d questions about current provision and a number of hypothetical scenarios to explore referral patterns to the cancer genetics service. The results of this study showed that referrals varied widely among specialists, as did t he numbers who required onward referral to cancer genetics. The offer of sc reening to women at high risk of ovarian cancer was consistent, although th ere were variations in how often it was offered and the age at which it was offered. Most gynaecologists were easily able to establish when it was app ropriate to refer onwards to cancer genetics, differentiating between women at high or low risk. There was some confusion about women at moderate risk of ovarian cancer. This study demonstrated the need for clear referral gui delines in Wales. Guidelines have since been distributed to all general pra ctitioners and specialists; however, continued monitoring and further evalu ation of referral practices will be necessary.