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Urol Oncol. 2018 Nov;36(11):501.e15-501.e21. doi: 10.1016/j.urolonc.2018.07.002. Epub 2018 Sep 3.

Physician attitudes about genetic testing for localized prostate cancer: A national survey of radiation oncologists and urologists.

Author information

1
University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH; Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH; Yale University, Cancer Outcomes and Public Policy Effectiveness Research (COPPER) Center, New Haven, CT. Electronic address: simkim@me.com.
2
Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH; Flatiron Health, New York, NY.
3
Yale University, Cancer Outcomes and Public Policy Effectiveness Research (COPPER) Center, New Haven, CT; Yale University, Department of Medicine, New Haven, CT.
4
Mayo Clinic, Department of Medicine, Rochester, MN.
5
University of Minnesota, Department of Urology, Minneapolis, MN.
6
Yale University, Cancer Outcomes and Public Policy Effectiveness Research (COPPER) Center, New Haven, CT; Yale University, Department of Radiation Oncology, New Haven, CT.
7
Cleveland Clinic, Glickman Urological and Nephrology Institute, Cleveland, OH; Louis Stokes VA Medical Center, Department of Urology, Cleveland, OH.
8
The University of Texas Medical Branch; Division of Urology; Galveston, TX.
9
Mayo Clinic, Division of Health Care Policy and Research, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.

Abstract

INTRODUCTION:

Genetic testing has been recently put forth as a strategy to improve decision-making in the management of localized prostate cancer. Little is known about how frequently prostate cancer specialists are using these tests, or whether they consider them important or effective. We performed a national survey of radiation oncologists and urologists on their perceptions and self-reported use of genetic testing.

METHODS:

From January to July 2017, a 4-wave mail survey was performed involving 915 radiation oncologists and 940 urologists about genetic testing and decision-making for localized prostate cancer. The survey queried the frequency and type of genetic test and the degree of importance and confidence of such tests. Pearson chi-square and multivariable logistic regression analyses were performed to identify respondent characteristics associated with outcomes.

RESULTS:

Overall response rate was 37.3% (n = 691). One in six specialists reported frequently using genetic tests with urologists more likely than radiation oncologists to do so (26% vs. 4%; OR: 3.51, p < 0.001) and their perceived higher importance (46% vs. 20%; adjusted OR: 3.51, p < 0.001) as well as their confidence in doing so (70% vs. 39%; OR: 3.81, p < 0.001) for decision-making for localized prostate cancer. Prolaris and Oncotype represented the most commonly cited tumor-based genetic testings.

CONCLUSIONS:

Few radiation oncologists and urologists report frequently using genetic testing for treatment decision-making among patients diagnosed with localized prostate cancer, though more urologists use these tests and believe they yield meaningful results.

KEYWORDS:

Biomarkers; Genetic testing; Genomics; Overtreatment; Prostate cancer; Survey; Treatment recommendations

PMID:
30190177
DOI:
10.1016/j.urolonc.2018.07.002
[Indexed for MEDLINE]

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