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To determine Alabama's primary care physicians' knowledge, attitudes, and behaviors regarding cancer genetics.A questionnaire was mailed to a random sample of 1,148 physicians: family and general practitioners, internists, and obstetrician—gynecologists.Of the surveyed physicians, 22.1% responded. Of the respondents, 63% to 85% obtained family histories of cancer from 76% to 100% of their patients. Obstetrician—gynecologists referred more patients for cancer genetic testing (p =.008) and were more confident in their abilities to tailor preventive recommendations based on the results (p =.05) than were the other physicians. Primary care physicians were more likely than were obstetrician—gynecologists to identify lack of time during the patient visit as hindering efforts to do genetic counseling (p =.01). Physicians in practice for ten years or less were more confident in explaining genetic test results than were those in practice for more than 20 years (p =.01).These data validate gaps in primary care practices in obtaining family history of cancer, as well as lack of confidence in explaining genetic test results and in tailoring recommendations based on the tests.