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Table 1 Studies examining type(s) of genomic knowledge among physicians

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)

United States [12, 15]

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