Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore; Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore.
Singapore Med J. 2023 Jan;64(1):67-73. doi: 10.4103/singaporemedj.SMJ-2021-467.
Genetic testing has the power to identify individuals with increased predisposition to disease, allowing individuals the opportunity to make informed management, treatment and reproductive decisions. As genomic medicine continues to be integrated into aspects of everyday patient care and the indications for genetic testing continue to expand, genetic services are increasingly being offered by non-genetic clinicians. The current complexities of genetic testing highlight the need to support and ensure non-genetic professionals are adequately equipped with the knowledge and skills to provide services. We describe a series of misdiagnosed/mismanaged cases, highlighting the common pitfalls in genetic testing to identify the knowledge gaps and where education and support is needed. We highlight that education focusing on differential diagnoses, test selection and result interpretation is needed. Collaboration and communication between genetic and non-genetic clinicians and integration of genetic counsellors into different medical settings are important. This will minimise the risks and maximise the benefits of genetic testing, ensuring adverse outcomes are mitigated.
基因检测具有识别具有疾病易感性增加的个体的能力,使个体有机会做出明智的管理、治疗和生殖决策。随着基因组医学不断融入日常患者护理的各个方面,基因检测的适应症不断扩大,越来越多的非遗传临床医生提供基因服务。当前基因检测的复杂性突出表明,需要支持并确保非遗传专业人员具备足够的知识和技能来提供服务。我们描述了一系列误诊/管理不当的病例,突出了基因检测中常见的陷阱,以确定知识差距和需要教育和支持的地方。我们强调需要关注鉴别诊断、测试选择和结果解释的教育。遗传和非遗传临床医生之间的协作和沟通以及将遗传咨询师整合到不同的医疗环境中非常重要。这将最大限度地降低基因检测的风险并最大程度地提高其益处,确保减轻不良后果。