General practice and new genetics: what do general practitioners know about community carrier screening for cystic fibrosis?

Abstract

As one of the first genetic conditions for which community carrier screening is possible, cystic fibrosis provides an opportunity to examine the way in which health professionals understand and assess issues associated with the clinical applications of the `new genetics'. This paper presents the results of a postal survey of general practitioners in the UK. Completed questionnaires were returned by 388 GPs (64%). The majority had a limited understanding of the epidemiology and population genetics of CF. Less than half (164, 44%) indicated the correct estimate of carrier frequency and only a third (144, 39%) indicated the correct likelihood of inheriting the carrier state. By contrast, the majority of GPs supported community carrier screening for CF. Almost all (339, 92%) felt the benefits of screening were important, and almost half (172, 45%) wanted to offer carrier screening in their own practices. These findings point to major gaps in GPs' understanding of genetics and raise further questions about the grounds on which their support for screening is based.

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References

Davison, C. , MacIntyre, S. , and Davey Smith, G. , 1994, The potential social impact of predictive genetic testing for susceptibility to common chronic diseases: a review and proposed research agenda. Sociology of Health and Illness, 16, 340-371.

Riordan, J. , Rommens, J. , Kerem, B. , et al. , 1989, Identification of the cystic fibrosis gene: cloning and characterisation of complementary DNA. Science, 245, 1066-1072.

Williamson, R. , 1993, Universal community carrier screening for cystic fibrosis? Nature Genetics, 3, 195-201.

Burn, J. , Magnay, D. , Claber, O. , and Curtis, A. , 1993, Population screening in cystic fibrosis. Journal of the Royal Society of Medicine, 86(suppl 20), 2-6.

Scriver, C. , Fujiwara, M. , 1992, Invited Editorial: Cystic fibrosis genotypes and views on screening are both heterogeneous and population related. American Journal of Human Genetics, 51, 943-950.

Raeburn, S. , 1994, Screening for carriers of cystic fibrosis (Leading article), British Medical Journal, 308, 1451-1452.

Mitchell, J. , Scriver, C. , Clow, C. , and Kaplan, F. , 1993, What young people think and do when the option for cystic fibrosis carrier testing is available, Journal of Medical Genetics, 30, 538-542.

Bekker, H. , Modell, M. , Denniss, G. , Silver, A. , Mathew, C. , Bobrow, M. , and Marteau, T. , 1993, Uptake of cystic fibrosis testing in primary care: supply push or demand pull? British Medical Journal, 306, 1584-1586.

Watson, E. , Mayall, E. , Lamb, J. , Chapple, J. , and Williamson, R. , 1992, Psychological and social consequences of community carrier screening programme for cystic fibrosis. Lancet, 340, 217-220.

10.

Smith, M. , 1992, An evaluation of population screening for carriers of cystic fibrosis. Journal of Public Health Medicine, 14, 257-263.

11.

Livingstone, J. , Axton, R. , Gilfillan, A. , Mennie, M. , Compton, M. , Liston, W. , Calder, A. , Gordon, A. , and Brock, D. , 1994, Antenatal screening for cystic fibrosis: a trial of the couple model. British Medical Journal, 308, 1459-1462.

12.

Mitchell, J. , Scriver, C. , Clow, C. , and Kaplan, F. , 1993, What young people think and do when the option for cystic fibrosis carrier testing is available. Journal of Medical Genetics, 30, 538-542.

13.

Qureshi, N. , and Raeburn, J. , 1993, Clinical genetics meets primary care (Leading article). British Medical Journal, 307, 816-817.

14.

Harper, P. , 1990, Genetics services in the community (Editorial). Journal of Medical Genetics, 27, 473-474.

15.

Qureshi, N. , and Raeburn, J. , 1993, Clinical genetics meets primary care (Leading article). British Medical Journal, 307, 816-817.

16.

Watson, E. , Williamson, R. , and Chapple, J. , 1991, Attitudes to carrier screening for cystic fibrosis. British Journal of General Practice, 41, 237-240.

17.

Davison, C. , Davey Smith, G. , Smith, G. , and Frankel, S. , 1991, Lay epidemiology and the prevention paradox. Sociology of Health and Illness, 13, 1-19.

18.

Mant, D. , Fowler, G. , 1990, Mass screening: theory and ethics. British Medical Journal, 300, 916-918.

19.

Calnan, M. , and Williams, S. , 1993, Coronary heart disease prevention: the role of the general practitioner. Family Practice, 10, 137-151.

20.

Williams, S. , and Calnan, M. , 1994, Perspectives on prevention: the views of general practitioners. Sociology of Health and Illness, 16, 372-393.