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Cancer Plan: Genetics
Knowledge about cancer genetics is rapidly expanding, with implications for all aspects of cancer management, including prevention, screening, and treatment. Even though all cancer is genetic, just a small portion, perhaps 5 – 10%, is inherited. Genetic information, including information from family history and from DNA-based testing, provides a means to identify people who have an increased risk of cancer. Family history often identifies people with a moderately increased risk of cancer. Less often, family history indicates the presence of an inherited cancer predisposition resulting in a relatively high lifetime risk of cancer.
Genetic assessment is likely to aid clinical decision-making only when management is based on genetic information (e.g., when the clinical interventions being considered would be offered to genetically susceptible people but not to those of average risk, or when interventions that are effective in people of average risk are ineffective in those with genetic susceptibility). Intrinsic benefits of genetic information, such as improvement in quality of life as a result of knowledge about genetic susceptibility, may be accompanied by potential personal and social risks as well. Genetic information may sometimes provide a direct health benefit by demonstrating the lack of a known inherited cancer susceptibility.
Gene tests for some cancers are also available. Specific genetic mutations have been identified as linked to several types of cancer, and, for certain types of cancer, this information has been converted into clinical tests. For example, scientists identified gene mutations that are linked to an inherited tendency to develop colon or breast cancer, and tests for an inherited susceptibility to these cancers are commercially available.
Genetic counseling has been defined by the American Society of Human Genetics as a communication process that deals with the human problems associated with the occurrence or risk of occurrence of a genetic disorder in a family. Genetic counseling generally involves some combination of rapport building and information gathering; establishing or verifying diagnoses; risk assessment and calculation of quantitative occurrence/recurrence risks; education and informed consent processes; psychosocial assessment, support, and counseling appropriate to a family’s culture and ethnicity.
Goal: Improve public and health care professional awareness of developments in cancer genetics.
Objective 1: Increase the number of referrals by 100% for cancer genetic services by 2010.
Baseline: 284 referrals and 138 consultations to cancer genetic services, Maine Center for Cancer Medicine, Maine Medical’s Cancer Risk and Prevention Clinic Program and Eastern Maine Medical Center, 2005.
Strategies
- Develop health care professional educational material on available cancer risk assessment services, and what the professionals can expect to receive with cancer risk assessment (genetic) services.
- Develop and disseminate public education materials regarding cancer genetics.
- Provide educational resources to Maine hospital staff by a cancer genetic professional.
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