A genetics challenge for doctors and patients alike

This week's BioNews reports on news from two cancer charities that general practitioners (GPs) are referring too many women for breast and ovarian cancer genetic tests. According to a joint report published by the Cancer Research Campaign (CRC) and the Imperial Cancer Research Fund (ICRF), many women coming to their GPs with worries about being at high risk of breast or ovarian cancer are being sent to specialist genetics centres unnecessarily.

Although a spokesman for the CRC was careful not to blame GPs for the problem, the Royal College of General Practitioners argued that GPs are in a no-win situation when it comes to referring such cases to genetics centres. Either they refer too often, causing patients to be anxious and genetics centres to be overworked, or they refer too infrequently, potentially leaving patients who are at high risk of developing breast or ovarian cancer ignorant of their situation.

We should have sympathy for GPs in this position. As generalists, they cannot be expected to know everything about everything and keep up with latest research in specialists areas of medicine. Compounding this problem are patients who, as members of the public, are exposed to more and more news stories about genetics and its involvement in common diseases. As a result, patients are making more and more enquiries about the role of genetics in common diseases - enquiries which GPs are finding difficult to answer.

Of course, one way of addressing the problem of GPs' limited understanding of cancer genetics is to provide them with more information. The CRC and ICRF are helping the situation by issuing general practices with guidelines on when to refer patients to specialist genetics centres. But we also need to educate patients, so that they are better able to work out for themselves whether they have an inherited cancer in their family or not. As awareness of genetics increases in the general population, let's hope that a better understanding of its role in common disease increases alongside.