Stratified Cancer Screening: The Practicalities of Implementation

被引：42

作者：

Dent, T. ^{[1
]}

Jbilou, J. ^{[10
]}

Rafi, I. ^{[4
]}

Segnan, N. ^{[11
,12
]}

Tornberg, S. ^{[13
]}

Chowdhury, S. ^{[1
]}

Hall, A. ^{[1
]}

Lyratzopoulos, G. ^{[2
]}

Eeles, R. ^{[8
,9
]}

Eccles, D. ^{[5
,6
]}

Hallowell, N. ^{[1
]}

Pashayan, N. ^{[7
]}

Pharoah, P. ^{[2
,3
]}

Burton, H. ^{[1
]}

机构：

[1] Univ Cambridge, PHG Fdn, Cambridge CB2 1TN, England

[2] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge CB2 1TN, England

[3] Univ Cambridge, Dept Oncol, Cambridge CB2 1TN, England

[4] Univ London, Dept Community Healthcare Sci, London WC1E 7HU, England

[5] Univ Southampton, Southampton SO9 5NH, Hants, England

[6] Princess Anne Hosp, Wessex Reg Genet Serv, Southampton, Hants, England

[7] UCL, Ctr Appl Hlth Res, London WC1E 6BT, England

[8] Inst Canc Res, Div Canc Genet & Epidemiol, Sutton, Surrey, England

[9] Royal Marsden NHS Fdn Trust, Sutton, Surrey, England

[10] Univ Sherbrooke, Med Training Ctr New Brunswick, Dept Community Hlth, Moncton, NB, Canada

[11] CPO Piemonte & S Giovanni Univ Hosp, Dept Canc Screening, Turin, Italy

[12] CPO Piemonte & S Giovanni Univ Hosp, Canc Epidemiol Unit, Turin, Italy

[13] Karolinska Univ Hosp, Dept Screening Reg Canc Ctr, Stockholm, Sweden

来源：

PUBLIC HEALTH GENOMICS | 2013年 / 16卷 / 03期

关键词：

Cancer; Implementation; Risk; Screening; Stratification; HEALTH;

D O I：

10.1159/000345941

中图分类号：

Q3 [遗传学];

学科分类号：

071007 ; 090102 ;

摘要：

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. Copyright (C) 2013 S. Karger AG, Basel

引用

页码：94 / 99

页数：6

共 12 条

[11] Polygenes, risk prediction, and targeted prevention of breast cancer [J].