Primary Care Screening for Hereditary Cancers. M. Kramer¹, J. Rispoli¹, T. Pollin¹, N. Khanna², S. DeLany¹. 1) Genetic Counseling; University of Maryland, School of Medicine, Baltimore, MD; 2) Family Medicine; University of Maryland, Baltimore, MD.
   Limitations in screening for hereditary cancer in primary care settings have been identified by several studies. In order to increase screening ability, physicians stated that they would like further education on screening patients for hereditary cancer. A study was conducted at the University of Maryland School of Medicine to determine what aspects of screening need improvement and what educational approaches would be preferred. 48 primary care physicians completed a questionnaire that asked about their practice and confidence in screening for hereditary cancers. They were also asked to assess cancer risk from four family history vignettes. Only 8% of physicians screened all patients regularly. A majority (88%) of physicians screened patients by asking about a presence or absence of a family history of cancer. Only 42% of respondents obtained a three-generation family history. Participants cited lack of time as the greatest barrier to hereditary cancer screening. No respondent correctly estimated risk as low, moderate or high, in more than 3 of 4 scenarios. Participants had the most difficulty assessing risk for low and moderate risk patients, resulting in overestimation of risk for inheriting a predisposition gene for cancer. Physicians (87%) stated that they would like more education on screening for hereditary cancer and that they would attend yearly lectures. Physicians indicated that they would particularly appreciate more information on cancer susceptibility tests and identifying high-risk patients. Only half of participants knew about local genetics services. These data indicate a need for further education of primary care physicians regarding both screening techniques and availability of resources and point toward some of the preferred means of providing this education.