OBJECTIVE: To explore family physicians' experiences in dealing with genetic susceptibility to cancer. DESIGN: Qualitative study using focus groups. SETTING: Four Ontario sites: northern, rural, urban, and inner city. PARTICIPANTS: Forty rural and urban FPs participated in four focus groups: 28 were male; average age was 41. METHOD: Focus groups using a semistructured interview guide were audiotaped and transcribed. The constant comparative method of data analysis was used. Key words and concepts were identified. Data were sorted using NUD*IST software. MAIN FINDINGS: Participants realized the escalating expectations for genetic testing and its effect on family practice. They explored an expanded role for themselves in genetic testing. Possible activities included risk assessment, gatekeeping, and ordering genetic tests. They were concerned about the complexity of genetic testing, the lack of evidence regarding management, and the implications for families. CONCLUSION: We must help FPs struggling to integrate genetics into their practices, by addressing their concerns, enhancing the way they communicate information on genetics, and developing appropriate educational tools.