The current study analyzed data from the 2000 and 2005 National Health Interview Surveys, both of which included supplementary questions assessing cancer control. More than 35,000 women participating in those surveys did not have a personal history of breast or ovarian cancer, and around 1 percent of them were determined to be at high risk because a mother, sister or daughter had such a tumor. Among these high-risk women, about half were aware that genetic testing was available, but only 10 percent had discussed it with a physician, less than 5 percent had been advised to have the test, and only 2 percent had done so.

"A patient's personal preferences are paramount in her decision to undergo genetic testing, but at the very minimum high-risk patients should have a discussion with their clinician." Levy explains. "Although we didn't examine factors that may impede these discussions, I believe that improvements won't come until it becomes easier and more routine to collect, update and interpret family history information, which could come through the availability of decision support tools based on electronic medical records.

"Right now we can stress that women should be aware of their family history of breast and ovarian cancer - on both sides of the family - communicate that information with their physicians and update it as necessary. Any woman concerned about her family history should not hesitate to raise the topic of testing with her physician," adds Levy, who is an assistant professor of Medicine at Harvard Medical School. "In addition, organizations dedicated to cancer prevention and treatment should help disseminate the guidelines - which have been updated in recent years - particularly to primary care physicians."

massgeneral/