Too many genetic tests?

A report from the Cancer Research Campaign and the Imperial Cancer Research Fund has said that many women are being unnecessarily referred by their general practitioners (GPs) for genetic tests for breast and ovarian cancer.

The two charities have suggested that a reason for the over referral may be the lack of confidence of family doctors in counselling patients about the risks of inherited cancers. As a result, women who have a family history of breast or ovarian cancer are sent for testing even where they are not at a higher than normal risk of developing the disease.

Dr Joan Austoker, a member of the Cancer Research Campaign's Primary Care Education Group based at Oxford University, said that 'doctors currently lack the appropriate information and err on the side of caution when assessing their patients' likely risk of cancer'. As a result, many patients are being unnecessarily alarmed.

But the report does not take into account the rise in demand from women who think they may be at risk, says Dr Jonathon Gray, who runs three clinics in Wales. He says that guidelines have been issued to GPs in his region in the past two years, to assist doctors in their assessment of patients and their decision whether or not to refer them to specialist care. The cancer charities are to produce an information pack for GPs which should help them decide which of their patients are at increased risk.

The report has also provoked criticism from the Royal College of General Practitioners, which believes GPs are in a no-win situation. Its chairman, Professor David Haslam, said that if GPs 'don't refer they are criticised, but they are criticised if they do refer as well'.