• familial breast/ovarian cancer
• general practitioner
• education

There has been a substantial increase in referrals from primary to secondary care of people with a family history of breast and/or ovarian cancer. The Harper report on Genetics and Cancer Services¹ recommended that subjects at low risk of developing an inherited form of breast and/or ovarian cancer (that is, similar to or only slightly higher than the population risk) should receive reassurance and advice in primary care. However, referrals from primary care are often of subjects at low risk, possibly because of GPs’ reported lack of knowledge and confidence in this area.² To address this need we developed an information pack and accompanying in practice educational session, aiming at improving GP management of familial breast and/or ovarian cancer. We then conducted a cluster randomised controlled trial to evaluate these educational interventions. We hypothesised that GPs exposed to both the educational session and the information pack would make more appropriate referrals than those GPs who were mailed the pack, who in turn would do better than GPs who received neither intervention. The findings of the first phase of the evaluation, which assessed GPs’ ability to assess risk using family history vignettes, have been reported elsewhere.³ This report presents the findings of a referral audit conducted in the 22 months after intervention.1