Cancers related to genetic mutations: important psychosocial issues for Canadian family physicians.

OBJECTIVE To review psychosocial issues family physicians might wish to be aware of when discussing genetic testing for predisposition for cancer with their patients. QUALITY OF EVIDENCE Articles from academic journals were reviewed. Studies provided level II and III evidence. MAIN MESSAGE Family physicians should be prepared to explore their patients' decisions for or against genetic testing, as well as to discuss the possible outcomes of a decision to test. While genetic testing has many potential benefits, patients are at risk of having psychosocial problems at many stages in a genetic testing inquiry. To minimize these problems, family physicians should discuss motivation for testing and the potential psychosocial effect of both deciding to undergo and deciding to forgo genetic testing for cancer-related genes. Also important are deciding whether patients qualify for the tests; coping with the waiting period before testing can be done; and discussing positive, negative, and inconclusive outcomes of testing. CONCLUSION Family physicians are likely in the best position to discuss genetic testing for predisposition for cancer with their patients given their knowledge of both the tests and their patients' ability to cope with testing.