Many US doctors wary of genetic testing

(HealthDay)—Many American doctors may not support genetic testing in patients without a major family history of certain illnesses, suggests a new survey of physicians. The report appears in the Nov. 13 issue of the New England Journal of Medicine.

The survey asked readers of the New England Journal of Medicine to consider genetic testing in a fictional 45-year-old patient who requested it. The hypothetical man didn't appear to have any significant risks based on his health or family history. When presented with this hypothetical case of a middle-aged man with a family history of cancer in an aunt and uncle, more than a third (37 percent) of U.S. doctors surveyed said they wouldn't recommend any genetic testing. Almost half (46 percent) would only recommend testing for cancer genes, and fewer than one in five (17 percent) would recommend whole-genome testing.

Doctors responded from 77 countries. The responses from the United States were similar overall to those in the rest of the world. Of the 929 respondents, 74 wrote comments and expressed concern about what to tell the patient if testing showed a risk of cancer. Would the patient be stressed out or even be able to do anything? What about cost and the potential for discrimination against the patient based on his medical future? Some of the survey respondents said they wanted to get more information about illness in the patient's family.

"Cancer genetics has moved faster, both in terms of recognition of the role of genetic factors in familial predisposition and in terms of treatment decision-making for actual cancers, than has most other areas of genomics in medicine," Bruce Korf, M.D., professor of genetics at the University of Alabama at Birmingham, told HealthDay. "This may in part be due to the fact that cancer is very common and also to the fact that cancer is at its heart a genetic disease, and therefore the genes were more accessible to identification."

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