Journal of Genetic Counseling

, Volume 21, Issue 2, pp 305–325 | Cite as

Barriers to and Motivations for Physician Referral of Patients to Cancer Genetics Clinics

  • Carrie F. ProchniakEmail author
  • Lisa J. Martin
  • Erin M. Miller
  • Sara C. Knapke
Original Research


Although it is well known that under-referral of colon cancer patients to cancer genetics clinics is a chronic problem, no study has yet examined why physicians may be ordering testing independently rather than referring patients to cancer genetics clinics. The current study explored variables which may impact a physician’s preference for ordering testing independently or referring patients to outside cancer genetics experts. An online questionnaire, distributed to the membership of the American College of Gastroenterology and the American Society of Colorectal Surgeons, yielded responses from 298 physicians. Motivations to refer to cancer genetics clinics rather than order testing independently included fear of genetic discrimination and a belief that patients benefit from genetic counseling about the risks, benefits and consequences of testing. These results suggest that in order to increase referrals, genetic counselors must educate physicians about the unique benefits patients receive from participating in genetic counseling.


Genetic counseling Hereditary colorectal cancer Genetic testing Referral Risk assessment 



The authors would like to thank Dr. Jim Cranley of Digestive Health Network and Dr. J. Michael Guenther of Cranley Surgical Associates for providing guidance in developing the questionnaire, and Dr. Janice Rafferty of the University of Cincinnati Division of Colon and Rectal Surgery for sponsoring the study with the American Society of Colorectal Surgery. Thanks also to the staff and members of the American College of Gastroenterology and American Society of Colorectal Surgery for agreeing to participate in this project.


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Copyright information

© National Society of Genetic Counselors, Inc. 2011

Authors and Affiliations

  • Carrie F. Prochniak
    • 1
    Email author
  • Lisa J. Martin
    • 2
  • Erin M. Miller
    • 3
  • Sara C. Knapke
    • 4
  1. 1.Department of Women’s Health/OncologyAurora Health CareMilwaukeeUSA
  2. 2.Divisions of Biostatistics and Epidemiology and Human Genetics, Department of Pediatrics, Cincinnati Children’s Hospital Medical CenterUniversity of Cincinnati School of MedicineCincinnatiUSA
  3. 3.The Heart Institute, Cincinnati Children’s Hospital Medical CenterCincinnatiUSA
  4. 4.Division of Human Genetics, Cincinnati Children’s Hospital Medical CenterCincinnatiUSA

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