Experiences and expectations of the new genetics in relation to familial risk of breast cancer: a comparison of the views of GPs and practice nurses.

BACKGROUND Advances in genetics may change the practice of medicine in many ways. Ascertaining practitioners' perceptions about managing the risk of familial breast cancer can give an insight into the current and expected impact on general practice to inform relevant education. Little is known about the practice nurses' (PNs) views of the new genetics in comparison with those of the GP. OBJECTIVES Our aim was to describe and compare the views of GPs and PNs on their experiences and expectations of the new genetics in relation to managing familial risk of breast cancer. METHOD A questionnaire, assessing views on the current and future impact of genetic advances in general and on the management of women with a familial risk of breast cancer, was sent to all GPs and PNs in the 66 practices of the Cambridge and Huntingdon Health Authority. RESULTS There was a 69% response rate. The words 'cautious', 'mixed feelings', 'hopeful' and 'optimistic' were used most frequently in response to views on genetic advances, but PNs chose more positive words than GPs (P < 0.001). PNs were also more optimistic than GPs in relation to the future positive impact of genetics on practice (P < 0.0001). Sixty-one per cent of GPs and 45% of PNs agreed that genetic advances in relation to breast cancer were already affecting their work. A minority of practitioners had attended recent educational events in risk assessment for breast cancer, and only 8% of GPs reported a practice policy on familial breast cancer risk management. CONCLUSIONS GPs and PNs show a cautious optimism in relation to advances in genetics, with PNs most optimistic. Many perceive that genetic advances in relation to breast cancer are already affecting their workloads, yet educational attendance and practice policies are lacking. Given PN involvement, multi-professional education may be appropriate. Education about risk management, including family history and genetics, might be better integrated into more general teaching on the prevention and management of breast cancer, than taught alone.