Physician responses to questions about BRCA1 and 2 mutations, by specialty and practice characteristics
| Characteristics | Suppose you had a patient whose aunt or grandmother on her father’s side carries the BRCA1 gene mutation for breast/ovarian cancer syndrome. In your opinion, could your patient also be a carrier of this mutation?* | In your opinion, what percentage of female breast cancer patients have a BRCA1 or BRCA2 gene mutation?* | ||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Yes (%) | No (%) | Not sure (%) | OR† | 95% CI | <10 (%) | 10–100 (%) | Not sure (%) | OR‡ | 95% CI | |||||||||||||||
| *Unadjusted percentages representing physician responses are weighted to the U.S. population of physicians in the selected specialties. Row percentages may not add to 100% due to nonresponse to some items. †The dependent variable in the logistic regression model is awareness that a mutation can be inherited from father (referent category = no or not sure). Weighted odds ratios (OR) and 95% confidence intervals (CI) are adjusted for all variables in the table. ‡The dependent variable in the logistic regression model is understanding that <10% of female breast cancer patients carry a mutation (referent category = 10–100% or not sure). Weighted ORs and 95% CI are adjusted for all variables in the table. HMO, health maintenance organisation. | ||||||||||||||||||||||||
| Total | 37.5 | 10.6 | 49.0 | 33.8 | 27.4 | 36.7 | ||||||||||||||||||
| Medical specialty | ||||||||||||||||||||||||
| Family/general practice | 28.1 | 10.8 | 58.0 | 1.0 | – | 21.8 | 26.7 | 49.1 | 1.0 | – | ||||||||||||||
| Internal medicine | 37.3 | 11.3 | 47.7 | 1.3 | 0.9 to 1.8 | 29.5 | 30.8 | 36.6 | 1.4 | 0.9 to 2.0 | ||||||||||||||
| Obstetricians/gynaecologists | 51.9 | 11.9 | 34.4 | 2.0 | 1.3 to 3.0 | 53.6 | 29.3 | 16.5 | 3.0 | 1.9 to 4.6 | ||||||||||||||
| Oncologists | 66.8 | 7.6 | 21.8 | 3.4 | 2.2 to 5.3 | 71.0 | 21.5 | 4.2 | 5.7 | 3.6 to 9.0 | ||||||||||||||
| General surgeons | 45.0 | 13.7 | 38.8 | 1.7 | 1.1 to 2.7 | 57.8 | 20.5 | 20.9 | 4.6 | 2.9 to 7.4 | ||||||||||||||
| Gastroenterologists | 24.8 | 6.7 | 68.5 | 0.6 | 0.3 to 1.4 | 22.4 | 19.9 | 57.9 | 0.9 | 0.4 to 2.2 | ||||||||||||||
| Age | ||||||||||||||||||||||||
| ⩾60 | 37.3 | 5.8 | 53.4 | 1.0 | – | 28.7 | 19.7 | 49.2 | 1.0 | – | ||||||||||||||
| 40–59 | 36.7 | 11.6 | 48.5 | 0.9 | 0.6 to 1.3 | 34.7 | 27.5 | 35.6 | 1.4 | 0.9 to 2.0 | ||||||||||||||
| <40 | 40.2 | 11.0 | 46.6 | 1.1 | 0.7 to 1.8 | 34.8 | 33.7 | 29.8 | 1.6 | 0.9 to 2.6 | ||||||||||||||
| Cancer genetics services provided in past 12 months | ||||||||||||||||||||||||
| None | 33.3 | 9.2 | 54.5 | 1.0 | – | 27.6 | 28.3 | 41.8 | 1.0 | – | ||||||||||||||
| Did not order breast/ovarian cancer genetics tests, but did order other cancer genetics tests or referred patients elsewhere for testing or risk assessment | 45.3 | 12.6 | 40.6 | 1.2 | 0.8 to 1.6 | 45.2 | 27.5 | 26.4 | 1.4 | 1.0 to 1.9 | ||||||||||||||
| Ordered breast/ovarian tests but did not refer patients elsewhere | 54.6 | 17.0 | 25.0 | 1.6 | 0.8 to 3.3 | 55.8 | 21.3 | 19.5 | 2.3 | 1.1 to 4.7 | ||||||||||||||
| Both ordered a breast/ovarian test and referred patients elsewhere | 49.0 | 16.6 | 24.3 | 1.4 | 0.6 to 3.6 | 58.5 | 18.8 | 17.7 | 2.1 | 0.9 to 5.4 | ||||||||||||||
| Local facilities for genetic counselling and testing for inherited cancer risk | ||||||||||||||||||||||||
| No | 43.2 | 13.0 | 40.5 | 1.0 | – | 33.6 | 37.0 | 28.8 | 1.0 | – | ||||||||||||||
| Yes | 41.6 | 9.5 | 48.3 | 1.0 | 0.6 to 1.4 | 43.9 | 28.1 | 26.2 | 1.2 | 0.8 to 1.9 | ||||||||||||||
| Not sure | 28.6 | 7.7 | 61.4 | 0.7 | 0.4 to 1.0 | 20.6 | 24.4 | 52.7 | 0.6 | 0.4 to 1.0 | ||||||||||||||
| Clear guidelines or strategies are not available for managing patients with inherited cancer susceptibility mutations | ||||||||||||||||||||||||
| Agreed with statement, somewhat or strongly | 40.8 | 12.4 | 45.9 | 1.0 | – | 37.1 | 31.1 | 31.6 | 1.0 | – | ||||||||||||||
| Disagreed, somewhat or strongly | 42.1 | 6.5 | 47.5 | 1.1 | 0.7 to 1.7 | 39.9 | 26.4 | 33.7 | 1.0 | 0.6 to 1.6 | ||||||||||||||
| Not sure | 22.7 | 5.4 | 72.0 | 0.5 | 0.3 to 0.8 | 17.1 | 13.1 | 69.1 | 0.5 | 0.3 to 0.8 | ||||||||||||||
| Received cancer genetic test advertising | ||||||||||||||||||||||||
| No or not sure | 1.0 | – | 29.3 | 26.8 | 41.8 | 1.0 | – | |||||||||||||||||
| Yes | 1.3 | 0.9 to 1.8 | 45.7 | 29.8 | 23.7 | 1.2 | 0.8 to 1.6 | |||||||||||||||||
| Academic affiliation | ||||||||||||||||||||||||
| No | 36.6 | 9.8 | 51.0 | 1.0 | – | 31.8 | 26.3 | 40.0 | 1.0 | – | ||||||||||||||
| Yes | 39.8 | 11.9 | 45.3 | 1.0 | 0.8 to 1.3 | 37.4 | 30.0 | 31.1 | 1.0 | 0.7 to 1.3 | ||||||||||||||
| Specialties in the practice | ||||||||||||||||||||||||
| Single specialty | 36.9 | 10.9 | 49.3 | 1.0 | – | 33.9 | 27.0 | 37.2 | 1.0 | – | ||||||||||||||
| Multispecialty | 40.8 | 9.9 | 47.6 | 1.1 | 0.8 to 1.6 | 34.8 | 29.4 | 34.9 | 0.9 | 0.6 to 1.4 | ||||||||||||||
| Practice arrangement | ||||||||||||||||||||||||
| Full or part owner | 37.6 | 10.1 | 49.6 | 1.0 | – | 33.7 | 26.6 | 37.4 | 1.0 | – | ||||||||||||||
| Employee of physician practice, HMO, hospital, university, or clinic | 38.0 | 11.0 | 48.5 | 1.0 | 0.8 to 1.4 | 33.9 | 28.4 | 36.5 | 1.1 | 0.8 to 1.6 | ||||||||||||||