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Table of Contents
Vol. 16, No. 3, 2013
Issue release date: May 2013
Section title: Review
Public Health Genomics 2013;16:94-99
(DOI:10.1159/000345941)

Stratified Cancer Screening: The Practicalities of Implementation

Dent T. · Jbilou J. · Rafi I. · Segnan N. · Törnberg S. · Chowdhury S. · Hall A. · Lyratzopoulos G. · Eeles R. · Eccles D. · Hallowell N. · Pashayan N. · Pharoah P. · Burton H.
aPHG Foundation, and Departments of bPublic Health and Primary Care and cOncology, University of Cambridge, Cambridge, dDepartment of Community Healthcare Sciences, St George's, University of London, London, eUniversity of Southampton and Wessex Regional Genetics Service, Princess Anne Hospital, Southampton, fCentre of Applied Health Research, University College London, London, and gDivision of Cancer Genetics and Epidemiology, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK; hDepartment of Community Health, Université de Sherbrooke, Medical Training Centre of New Brunswick, Moncton, N.B., Canada; iDepartment of Cancer Screening and Unit of Cancer Epidemiology, CPO Piemonte and S. Giovanni University Hospital, Torino, Italy; jDepartment of Screening, Regional Cancer Centre, Karolinska University Hospital, Stockholm, Sweden

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Article / Publication Details

First-Page Preview
Abstract of Review

Received: 8/8/2012
Accepted: 11/20/2012
Published online: 1/26/2013

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 0

ISSN: 1662-4246 (Print)
eISSN: 1662-8063 (Online)

For additional information: http://www.karger.com/PHG

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.


Article / Publication Details

First-Page Preview
Abstract of Review

Received: 8/8/2012
Accepted: 11/20/2012
Published online: 1/26/2013

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 0

ISSN: 1662-4246 (Print)
eISSN: 1662-8063 (Online)

For additional information: http://www.karger.com/PHG


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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