Use of Genetic Cancer Testing Varied Widely

Oncologists used genomic testing for cancer differently

(RxWiki News) Genetic testing has been hailed by some as the wave of the future that will allow cancer treatment to be approached in a more personalized way. But how are doctors using these tests now?

Genetic tests typically explore a person's risk for developing cancer, or look for genetic information in DNA gathered from cancer patients' tumor samples, which may be used to make treatment decisions.

In a new study surveying cancer doctors, the results showed that use of the tests varied widely from doctor to doctor, as did doctors' confidence in their own understanding of the topic.

"Discuss ways to lower the risk for cancer with your doctor."

According to the authors of this new study, which was led by Stacy W. Gray, MD, AM, of the Department of Medical Oncology at the Dana-Farber Cancer Institute in Boston, developments in genomic testing that examine a patient's genetic code have the potential to transform certain aspects of cancer care, both in terms of predicting certain conditions and treating them. However, Dr. Gray and team noted that there is much to be learned about how doctors actually use these tests in practice.

To explore doctor's opinions and use of genomic testing, Dr. Gray and team executed a survey of all active cancer physicians working with adult patients at the Dana-Farber Cancer Institute/Brigham and Women’s Hospital in Boston. The survey took place from September 2011 to January 2012.

The survey included 160 cancer doctors, of whom 57 percent were medical oncologists, 29 percent were surgeons and 14 percent were radiation oncologists. A total of 37 percent of these physicians were female.

On average, these doctors reported using genomic tumor testing in 24 percent of patients.

Frequency of testing varied greatly, as 18 percent of the doctors anticipated testing patients infrequently (testing 10 percent of patients or fewer), and 25 percent anticipated testing most of their patients (testing 90 percent of patients or more).

Results of the survey showed that 22 percent of the doctors reported having low confidence in their own genomic knowledge, 14 percent reported low confidence in their ability to explain the concepts to their patients, and 26 percent reported low confidence in their ability to make treatment recommendations based on data from genomic tests. On average, the researchers found that most of the physicians were "somewhat confident" in these areas.

"Given that many physicians reported low genomic confidence, evidence-based guidelines and enhanced physician genomic education efforts may be needed to ensure that genomically guided cancer care is adequately delivered," wrote Dr. Gray and team.

It is important to note that the survey consisted of physicians at a single cancer center. Further research is needed to confirm these findings among a larger population of doctors.

"It is only through further study and a nuanced understanding of the physician-related factors that contribute to variations in genomic cancer care that we will be able to design and implement interventions promoting the appropriate adoption of these innovative technologies," explained the study's authors.

This study was published online March 24 by the Journal of Clinical Oncology.

One study author reported serving as a consultant for Merrimack Pharmaceuticals.

Review Date: 
March 26, 2014