University of California San Francisco
Helen Diller Family Comprehensive Cancer Center

Breast Oncology Program Seminar

January 9, 2019, 8:30 am – 10:00 am

Mount Zion
2340 Sutter Street
Lurie Seminar Room
San Francisco, CA 94143

Maren Scheuner, MD, MPH, UCSF   >view speaker profile

"Integration of cancer genetic services and applications into clinical practice"

Abstract: Timely diagnosis of hereditary cancer syndromes can be lifesaving across the cancer care continuum, from primary prevention to long-term survival. Individuals with an inherited cancer predisposition have increased risks for multiple primary cancers typically occurring at an age younger than usual and sometimes behaving more aggressively than usual. To manage the associated cancer risks, enhanced strategies for early detection and prevention are recommended. Moreover, if cancer is diagnosed, identifying a hereditary cancer syndrome can be critical to informing the extent of surgery (e.g., choosing bilateral mastectomy or subtotal colectomy rather than a conservative approach) and selecting targeted cancer treatment for patients with advanced disease (e.g., PARP inhibitors that target pathogenic variants in DNA damage response genes). Discovery of genes contributing to high- and moderate-risk cancer predisposition continues to increase, followed by rapid availability of valid clinical genetic testing applications. Traditionally, genetic testing for suspected inherited cancer predisposition has been offered in the context of pre- and post-test genetic counseling with a genetics health professional (i.e., genetic counselor or clinical geneticist) to ensure informed decision-making that considers potential benefits, harms, and limitations for the patient and their family members. However, the numbers of genetics professionals are not adequate to provide all clinical genetic services for every patient suspected to have an inherited cancer predisposition. Novel genetic healthcare models for delivery of genetic testing services that are effective, safe, and affordable are needed. At UCSF, we have multiple genetic healthcare models, making UCSF an ideal setting to investigate relevant outcomes at the patient, provider and health system level. This presentation will describe common hereditary cancer syndromes, available genetic testing for diagnosis of inherited cancer predisposition, genetic healthcare models for delivery of clinical genetic services, and the role of health services and implementation research to understand ideal care arrangements and best practices.

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