|
Hereditary cancer testing in community oncology practices
1 Wilshire Oncology Medical Group, Inc., La Verne, CA; 2 New York University Cancer Institute, New York, NY; 3 Texas Oncology Cancer Center, Austin, TX; and 4 Kansas City Cancer Center, Kansas City, MO
Approximately one fifth of all newly diagnosed cases of breast and colon cancers are at risk for a hereditary cancer syndrome. Mutations associated with hereditary breast and ovarian cancers (HBOC) and hereditary nonpolyposis colorectal cancer (HNPCC) significantly increase the risk of primary breast or ovarian cancer and colorectal or endometrial cancer, respectively, as well as other less common tumors. For patients with mutations associated with these syndromes, as well as other hereditary cancer syndromes, family members—especially first-degree relatives—also may be at risk for developing these malignancies. Therefore, identification of at-risk individuals, appropriate pre- and post-test risk assessment and counseling, and genetic testing for appropriate individuals are important aspects of oncology care. This article highlights general features of hereditary cancer syndromes, approaches to patient identification, and guidelines for testing and counseling within community-based oncology practices. Options for medical management, ranging from heightened cancer surveillance to prophylactic surgery, are discussed. Effective screening and counseling for these cancer syndromes, coupled with guidance regarding therapeutic options, present an opportunity for oncologists to have a significant impact on the lives of patients and their families through cancer prevention.
| Commun Oncol 2007;4(suppl 4):2–8 | full text |  127 kb |