From: Adopting clinical genomics: a systematic review of genomic literacy among physicians in cancer care
Study, year, country | Method | Sample | Type of cancer | Awareness Knowledge | How-to Knowledge | Principles Knowledge | Limitations |
---|---|---|---|---|---|---|---|
Bellcross et al. (2011) United States [13] | Survey (response rate = 48%) | 1500 physicians responded to 2007 DocStyles national survey | Breast-ovarian cancer | 87% of respondents were aware of BRCA testing but only 25% reported having ordered at least one test in the past year | N/A | Only 19% correctly selected all of the increased-risk and none of the low-risk scenarios as an indication for BRCA testing. 45% chose at least one low-risk scenario | Sample may not be truly representative of primary care providers in US |
Chow-White et al. (2017) Canada [1] | Survey (response rate = 52.5%) | 31 medical oncologists (MOs) involved in a cancer clinical genomics trial | Not specified | N/A | 67.8% of MOs somewhat and strongly agree that they feel confident to communicate genomic results to their patients. 58.1% of the MOs felt more confident making treatment decisions after becoming informed about patients’ genome. | MOs acknowledged they had little knowledge about never genomic technologies (50%) and whole genome sequencing process (41%). MOs located in urban/suburban areas tend to have higher genomic literacy than those located in rural areas. | Knowledge was self-reported Low number of respondents |
Dressler et al. (2014) United States [14] | Survey | 94 medical, surgical, and hematologic oncologists practicing in academic and community settings in North Carolina | Breast and Colorectal cancer | In one area, clinicians were not well aware with the term ‘pharmacogenomics’ | 37% of oncologists were comfortable in interpreting PGx test results. The use for breast cancer PGx testing vary: 100% for HER2 testing, 97% for Breast Oncotype Dx test, and 32% for CYP2D6 testing. Only 26% used Oncotype Dx for colon cancer. | Few oncologists were comfortable with their PGx knowledge (33%). Oncologists with less than 10 years of practice (48%) reported being more comfortable with their PGx knowledge than those with more than 10 years practice (21%). | Small sample no indication of required size |
Freedman et al. (2003) United States [18] | 15-min survey (response rate = 71%) | 1251 physicians from 8 specialties | Not specified | N/A | Only 29% of physicians reported feeling qualified to provide genetic counselling for cancer susceptibility. Oncologists (84%) considered themselves more qualified to recommend genetic testing than primary care physicians (40%), and tertiary care physicians (57%) | N/A | Study measurement was self-reported |
Gingras et al. (2016) Multi-countries [16] | 28-item survey | 215 physicians, of which 88% were MOs, practicing in Europe (70%) and working in academic institutions (66%) | Breast cancer | N/A | 38% had used tumor genome sequencing for their breast cancer patients at least once in the past | 21% reported low confidence in their genomic knowledge. | Small sample no indication of required size Article structure not well elucidated |
Gray et al. (2014) United States [21] | Cross-sectional survey (response rate = 61%) | 160 physicians including medical oncologists, surgeons, radiation oncologists | Not specified | N/A | N/A | 22% reported low confidence in their genomic knowledge | Small sample size Study measurement was self-reported |
Gray et al. (2016) United States [20] | Surveys (response rate = 92%) and Interviews | 27 oncologists | Lung + Colorectal cancer | N/A | Oncologists had extensive experience ordering somatic tests (median = 100/year) but little experience ordering germline cancer predisposition tests per year (median = 2/year). | N/A | Small number of survey respondents Survey measures were self-reported |
Koil et al. (2003) United States [19] | Survey (response rate = 25%) | 214 physicians in Ohio’s tri-state region | Breast cancer | N/A | 51% of the respondents reported having ever refereed for an indication of hereditary breast cancer. Rural-practice physicians were less likely to have ever referred for breast cancer testing than urban- and suburban-practice physicians combined | N/A | Low response rate Overall response bias for physicians with greater interest and experience in hereditary breast cancer |
Marzuillo et al. (2013) Italy [17] | Survey (response rate = 69.6%) | 1079 physicians | Breast + Colorectal cancer | N/A | Few physicians in the sample had either referred patients for predictive genetic testing for breast (10%) or colorectal cancer (4.7%) in the previous 2 years. | 42.8% of the sample answered correctly all three knowledge questions about BRCA1/2 testing. 16.9% answered correctly about APC testing. | High percentage of non-responders Information about specialties was not adequate for meaningful comparisons |
Wideroff et al. (2003, 2005) | 15-min questionnaire (response rate = 71%) | 1251 physicians (820 in primary care, 431 in selected subspecialties) | Breast+ ovarian+ Colorectal cancer | 37.5% was aware of paternal inheritance of BRCA 1/2 mutations and 33.8% was aware that these mutations occur in < 10% of breast cancer patients | 31.2% physicians in the sample, including 30.6% in primary care and 33.4% in tertiary care, had ordered cancer susceptibility tests (CSTs) or referred patients elsewhere for risk assessment or testing | One third of the sample accurately responded that less than 10% of breast cancer patients carry BRCA1/2 mutations. Only 13.1% accurately identified HNPCC gene penetrance as > 50%. OBGY, physicians, oncologists, and general surgeons were significantly more likely to respond correctly to breast/ovarian cancer questions, as were gastroenterologists to the HNPCC question | Ambiguous term for commercial availability. Small specialty subgroups |