Knowledge and practice toward hereditary lung cancer in Brazil: A GBOT (Grupo Brasileiro de Oncologia Torácica) national survey.

Abstract

e20780 Background: Non–small cell lung cancer (NSCLC) in never smokers represents 10–25% of cases and shows distinct epidemiologic and molecular features. Although hereditary predisposition to lung cancer has been increasingly recognized, there is still no consensus regarding which patients may benefit from germline genetic testing. This study assessed the knowledge, perceptions, and clinical practices of Brazilian healthcare professionals dedicated to lung cancer regarding inherited lung cancer. Methods: We conducted a national, anonymous, electronic survey with 20 questions distributed to professionals involved in lung cancer care in Brazil. The questionnaire assessed demographics, clinical practice, access to genetic testing and counseling, referral criteria, and knowledge related to hereditary lung cancer. Results: A total of 86 participants completed the survey. Most respondents were aged 30–50 years (76.7%), and 42.9% were from Southeastern Brazil. Medical oncologists comprised 54.6% of respondents, followed by thoracic surgeons (20.8%). Nearly 90% worked in the private or mixed settings, and 94.7% currently treated lung cancer patients.Most respondents (96%) believed lung cancer may have a hereditary component, although estimates of its frequency varied widely. Family history was routinely collected by 97%, and 85.7% had previously treated patients with a family history of lung cancer. Approximately 60% reported access to germline genetic testing, 50% had managed patients with known pathogenic germline variants, and 70% had access to genetic counseling, with 65.8% having referred at least one lung cancer patient for evaluation. Common referral criteria included diagnosis before age 50 (67%), never-smoking status (62.6%), Ashkenazi ancestry (67%), family history of lung cancer (68%), and multiple primary tumors (64.8%). The most cited genes were TP53 (62.6%), EGFR (53.8%), and BRCA1/2 (44%). Li–Fraumeni syndrome was the most frequently recognized hereditary syndrome associated with lung cancer (62.6%). Almost all participants (98.7%) agreed that further studies are needed to better define the role of inherited predisposition in lung cancer. Conclusions: Brazilian healthcare professionals widely recognize the possibility of hereditary predisposition to lung cancer; however, knowledge regarding specific genes, syndromes, and referral criteria remains heterogeneous. These results highlight essential gaps in education and reinforce the need for broader awareness initiatives and prospective studies to better define indications for germline testing in lung cancer, particularly among never smokers.