Stratified Cancer Screening: The Practicalities of Implementation
- 26 January 2013
- journal article
- review article
- Published by S. Karger AG in Public Health Genomics
- Vol. 16 (3), 94-99
- https://doi.org/10.1159/000345941
Abstract
Background: Improving understanding of the genetic basis of disease susceptibility enables us to estimate individuals' risk of developing cancer and offer them disease prevention, including screening, stratified to reflect that risk. Little attention has so far been given to the implementation of stratified screening. This article reviews the issues that would arise in delivering such tailored approaches to prevention in practice. Results: Issues analysed include the organisational context within which implementation of stratified prevention would occur, how the offer of screening would be made, making sure consent is adequately informed, how individuals' risk would be assessed, the age at which risk estimation should occur, and the potential use of genetic data for other purposes. The review also considers how management might differ depending on individuals' risk, how their results would be communicated and their follow-up arranged, and the different issues raised by modification of an existing screening programme, such as that for breast cancer, and the establishment of a new one, for example for prostate cancer. Conclusion: Stratified screening based on genetic testing is a radically new approach to prevention. Various organisational issues would need to be considered before it could be introduced, and a number of questions require further research.Keywords
This publication has 9 references indexed in Scilit:
- The benefits and harms of breast cancer screening: an independent reviewThe Lancet, 2012
- MRI for breast cancer screening, diagnosis, and treatmentThe Lancet, 2011
- Polygenic susceptibility to prostate and breast cancer: implications for personalised screeningBritish Journal of Cancer, 2011
- Biology and Data-Intensive Scientific Discovery in the Beginning of the 21st CenturyOMICS: A Journal of Integrative Biology, 2011
- Genetic testing and common disorders in a public health framework: how to assess relevance and possibilitiesEuropean Journal of Human Genetics, 2011
- Population-based mammography screening below age 50: balancing radiation-induced vs prevented breast cancer deathsBritish Journal of Cancer, 2011
- Utility of genetic determinants of lipids and cardiovascular events in assessing riskNature Reviews Cardiology, 2011
- Health systems, health, and wealth: a European perspectiveThe Lancet, 2009
- Polygenes, Risk Prediction, and Targeted Prevention of Breast CancerThe New England Journal of Medicine, 2008