When cascade testing for familial variant seems inadequate to provide clinically actionable information for blood relatives

2021 ◽  
Vol 258-259 ◽  
pp. 49-50
Author(s):  
Paraskevi Apostolou ◽  
Florentia Fostira ◽  
George Fountzilas ◽  
Evangelia Razis ◽  
Drakoulis Yannoukakos ◽  
...  
Keyword(s):  
2020 ◽  
Author(s):  
A Lackner ◽  
X Li ◽  
R Kahn ◽  
Nelson B Baltich ◽  
H Krinsky ◽  
...  
Keyword(s):  

2021 ◽  
Vol 11 (6) ◽  
pp. 543
Author(s):  
Anna DiNucci ◽  
Nora B. Henrikson ◽  
M. Cabell Jonas ◽  
Sundeep Basra ◽  
Paula Blasi ◽  
...  

Ovarian cancer (OVCA) patients may carry genes conferring cancer risk to biological family; however, fewer than one-quarter of patients receive genetic testing. “Traceback” cascade testing —outreach to potential probands and relatives—is a possible solution. This paper outlines a funded study (U01 CA240747-01A1) seeking to determine a Traceback program’s feasibility, acceptability, effectiveness, and costs. This is a multisite prospective observational feasibility study across three integrated health systems. Informed by the Conceptual Model for Implementation Research, we will outline, implement, and evaluate the outcomes of an OVCA Traceback program. We will use standard legal research methodology to review genetic privacy statutes; engage key stakeholders in qualitative interviews to design communication strategies; employ descriptive statistics and regression analyses to evaluate the site differences in genetic testing and the OVCA Traceback testing; and assess program outcomes at the proband, family member, provider, system, and population levels. This study aims to determine a Traceback program’s feasibility and acceptability in a real-world context. It will account for the myriad factors affecting implementation, including legal issues, organizational- and individual-level barriers and facilitators, communication issues, and program costs. Project results will inform how health care providers and systems can develop effective, practical, and sustainable Traceback programs.


Author(s):  
Alexandra Cernat ◽  
Robin Z. Hayeems ◽  
Wendy J. Ungar

AbstractCascade genetic testing is the identification of individuals at risk for a hereditary condition by genetic testing in relatives of people known to possess particular genetic variants. Cascade testing has health system implications, however cascade costs and health effects are not considered in health technology assessments (HTAs) that focus on costs and health consequences in individual patients. Cascade health service use must be better understood to be incorporated in HTA of emerging genetic tests for children. The purpose of this review was to characterise published research related to patterns and costs of cascade health service use by relatives of children with any condition diagnosed through genetic testing. To this end, a scoping literature review was conducted. Citation databases were searched for English-language papers reporting uptake, costs, downstream health service use, or cost-effectiveness of cascade investigations of relatives of children who receive a genetic diagnosis. Included publications were critically appraised, and findings were synthesised. Twenty publications were included. Sixteen had a paediatric proband population; four had a combined paediatric and adult proband population. Uptake of cascade testing varied across diseases, from 37% for cystic fibrosis, 39% to 65% for hypertrophic cardiomyopathy, and 90% for rare monogenic conditions. Two studies evaluated costs. It was concluded that cascade testing in the child-to-parent direction has been reported in a variety of diseases, and that understanding the scope of cascade testing will aid in the design and conduct of HTA of emerging genetic technologies to better inform funding and policy decisions.


2012 ◽  
Vol 161 (1) ◽  
pp. 59-69 ◽  
Author(s):  
Page L. Sorensen ◽  
Louise W. Gane ◽  
Mark Yarborough ◽  
Randi J. Hagerman ◽  
Flora Tassone

2020 ◽  
Vol 159 ◽  
pp. 257
Author(s):  
K.E. Baumann ◽  
A.L. Brodsky ◽  
B. Bhuptani ◽  
K. Lutz ◽  
D. Gerber ◽  
...  

2017 ◽  
Vol 112 ◽  
pp. S121-S122
Author(s):  
Shivali Berera ◽  
Fernando H. Calmet ◽  
Rachel Silva-Smith ◽  
Daniel A. Sussman

2020 ◽  
pp. 96-108 ◽  
Author(s):  
Nawal Kassem ◽  
Leigh Anne Stout ◽  
Cynthia Hunter ◽  
Bryan Schneider ◽  
Milan Radovich

The identification of cancer-predisposing germline variants has potentially substantial clinical impact for patients and their families. Although management guidelines have been proposed for some genes, guidelines for other genes are lacking. This review focuses on the current surveillance and management guidelines for the most common hereditary cancer syndromes and discusses some of the most pivotal studies supporting the available guidelines. We also highlight the gaps in the identification of germline carriers, the cascade testing of at-risk relatives, and the challenges impeding the proper follow-up and optimal management of pathogenic germline carriers. The anticipated surge in the number of identified germline carriers, deficient management guidelines, poor cascade testing uptake, and long-term follow-up necessitate the development of multidisciplinary clinics as an obligatory step toward the improvement of cancer prevention.


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