Calzone K A, Stopfer J, Blackwood A, Weber B L
University of Pennsylvania Cancer Center, Department of Medicine, Philadelphia, USA.
Cancer Pract. 1997 Jul-Aug;5(4):228-33.
Presymptomatic genetic testing for cancer susceptibility is a new practice arena that raises many complex issues. This article presents one model of a cancer risk evaluation program that specifically addresses the unique issues associated with genetic testing for cancer risk.
The Cancer Risk Evaluation Program is designed to care for any individual concerned about his or her risk for cancer, offering predisposition genetic testing if appropriate. The program includes clinical and psychosocial assessment, education, cancer risk analysis, and genetic counseling; it offers long-term screening and surveillance and provides a forum for ongoing genetic and clinical research.
Program evaluations from participants have shown that the program is successfully meeting the needs of the participants. This program also ensures that the University of Pennsylvania Cancer Center is delivering cancer genetic services consistent with the existing position statements on genetic testing for cancer susceptibility, which have included guidelines and indications for predisposition genetic testing and informed consent.
Researchers anticipate a substantial demand for predisposition genetic testing for cancer susceptibility. However, not all individuals interested in testing are eligible or willing to undergo direct gene analysis because of the potential risks. Therefore, clinical programs must address the complex issues surrounding presymptomatic genetic testing and incorporate cancer risk assessment strategies. Additionally, healthcare providers in this new practice arena should be fully informed and current in the state of the knowledge regarding cancer risk assessment; predisposition genetic testing; and the ethical, legal, and social issues pertaining to cancer risk assessment and management.
对癌症易感性进行症状前基因检测是一个新的实践领域，引发了许多复杂问题。本文介绍了一种癌症风险评估项目模式，该模式专门解决与癌症风险基因检测相关的独特问题。
癌症风险评估项目旨在为任何关注自身患癌风险的个人提供护理，并在适当情况下提供易感性基因检测。该项目包括临床和心理社会评估、教育、癌症风险分析以及遗传咨询；它提供长期筛查和监测，并为正在进行的基因和临床研究提供一个平台。
参与者的项目评估表明，该项目成功满足了参与者的需求。该项目还确保宾夕法尼亚大学癌症中心提供的癌症基因服务符合关于癌症易感性基因检测的现有立场声明，这些声明包括易感性基因检测的指南和适应症以及知情同意。
研究人员预计对癌症易感性的易感性基因检测需求会大幅增加。然而，由于潜在风险，并非所有对检测感兴趣的个体都有资格或愿意接受直接基因分析。因此，临床项目必须解决围绕症状前基因检测的复杂问题，并纳入癌症风险评估策略。此外，这个新实践领域的医疗服务提供者应该充分了解并紧跟有关癌症风险评估、易感性基因检测以及与癌症风险评估和管理相关的伦理、法律和社会问题的知识现状。
