Physician attitudes about genetic testing for localized prostate cancer: A national survey of radiation oncologists and urologists

Introduction: Genetic testing has been recently put forth as a strategy to improve decision-making in the management of localized prostate cancer. Little is known about how frequently prostate cancer specialists are using these tests, or whether they consider them important or effective. We performed a national survey of radiation oncologists and urologists on their perceptions and self-reported use of genetic testing. Methods: From January to July 2017, a 4-wave mail survey was performed involving 915 radiation oncologists and 940 urologists about genetic testing and decision-making for localized prostate cancer. The survey queried the frequency and type of genetic test and the degree of importance and confidence of such tests. Pearson chi-square and multivariable logistic regression analyses were performed to identify respondent characteristics associated with outcomes. Results: Overall response rate was 37.3% (n = 691). One in six specialists reported frequently using genetic tests with urologists more likely than radiation oncologists to do so (26% vs. 4%; OR: 3.51, p < 0.001) and their perceived higher importance (46% vs. 20%; adjusted OR: 3.51, p < 0.001) as well as their confidence in doing so (70% vs. 39%; OR: 3.81, p < 0.001) for decision-making for localized prostate cancer. Prolaris and Oncotype represented the most commonly cited tumor-based genetic testings. Conclusions: Few radiation oncologists and urologists report frequently using genetic testing for treatment decision-making among patients diagnosed with localized prostate cancer, though more urologists use these tests and believe they yield meaningful results.