Identifying and evaluating the disparities in familial cancer genetic testing and genetic counselling based on geographical location in Australia.

As the study of genetics gains increasing relevance across all areas of medicine, emerging evidence reveals inconsistencies in the utilisation of genetic risk services for familial cancer. Existing literature emphasises an inequality of familial cancer genetic care for individuals who are geographically isolated from familial cancer genetic services. This is an issue that needs to be addressed to improve assessment of risk for any hereditary malignant disease and timely preventative strategies for the individuals ‘at risk,’ including those whose access to these services is limited. The research hypothesis is that an unequal number of GPs initiate familial cancer referrals and genetic testing based on geographic location in Australia. The purpose of this research was to review and determine the extent and strength of the published literature regarding familial cancer referral patterns in Australia. Most importantly it also specifically examined the diverse approach of General Practitioners (GPs) in referral rates for familial cancer genetic testing and counselling, and the influences and barriers to these referrals. Furthermore, this study investigated contributing factors that lead to enhanced effectiveness of familial cancer genetic risk care in relation to the geographical location throughout Australia. This research contributes to existing knowledge by highlighting the importance of genetic testing for predisposition to familial cancer as a routine part of familial cancer screening and as an essential step towards the improvement of familial cancer health care. In answering important research questions this study has offered several insights into issues particularly relating to access to familial cancer genetic risk assessment for all Australians, regardless of their place of residence. This project informs a rationale behind the gaps in referral patterns for familial cancer genetic risk evaluation being influenced by the geographic location. This study serves as a good starting point to create and improve educational pathways for GPs’ capabilities and confidence with referrals for familial cancer genetic testing and genetic counselling. The emerging evidence encourages renewed commitment to strengthen familial cancer health management, especially in remote areas of Australia.