Cancer Risk Assessment by Rural and Appalachian Family Medicine Physicians

Autor/inn/en	Kelly, Kimberly M.; Love, Margaret M.; Pearce, Kevin A.; Porter, Kyle; Barron, Mary A.; Andrykowski, Michael
Titel	Cancer Risk Assessment by Rural and Appalachian Family Medicine Physicians
Quelle	In: Journal of Rural Health, 25 (2009) 4, S.372-377 (6 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-765X
DOI	10.1111/j.1748-0361.2009.00246.x
Schlagwörter	Physicians; Testing; Cancer; Identification; Family Practice (Medicine); Patients; Genetics; Factor Analysis; Genealogy; At Risk Persons; Rural Areas; Geographic Regions; Screening Tests; Diagnostic Tests; Self Efficacy; Access to Health Care; Intervention + Suchen Sie Ihr Suchwort? Physician; Doctor; Arzt; Testdurchführung; Testen; Carcinoma; Karzinom; Krebs (med); Krebserkrankung; Identifikation; Identifizierung; Patient; Humangenetik; Faktorenanalyse; Ahnenforschung; Genealogie; Risikogruppe; Rural area; Ländlicher Raum; Screening-Verfahren; Diagnostic test; Diagnostischer Test; Self-efficacy; Selbstwirksamkeit
Abstract	Context: Challenges to the identification of hereditary cancer in primary care may be more pronounced in rural Appalachia, a medically underserved region. Purpose: To examine primary care physicians' identification of hereditary cancers. Methods: A cross-sectional survey was mailed to family physicians in the midwestern and southeastern United States, stratified by rural/non-rural and Appalachian/non-Appalachian practice location (n = 176). Identification of hereditary breast-ovarian cancer (BRCA1/2), hereditary non-polyposis colon cancer (HNPCC), and other hereditary cancers was assessed. Findings: Less than half of physicians (45%) reported having patients with cancer genetic testing. Most (70%) correctly identified the BRCA1/2-relevant scenario; 49% correctly identified the HNPCC-relevant scenario. Factor analysis of psychosocial variables revealed 2 factors: Confidence (knowledge, comfort, confidence) and importance (responsible, important, effective, need) of identifying hereditary cancer. Greater confidence was associated with use of 3 generation pedigree in taking family history. Greater knowledge and access to genetic services were associated with use of genetic testing. More recent graduation year, greater knowledge, and greater confidence were associated with identifying the BRCA1/2-relevant scenario. Greater knowledge and confidence were associated with identifying the HNPCC-relevant scenario. Conclusions: Though rural Appalachian physicians do not differ in ability to identify high risk individuals, access barriers may exist for genetic testing. Interventions are needed to boost physician confidence in identifying hereditary cancer and to improve availability and awareness of availability of genetic services. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10