The emerging role of the physician in genetic counselling and testing for heritable breast, ovarian and colon cancer

Kathryn M. Taylor, PhD; Merrijoy J. Kelner, PhD

Canadian Medical Association Journal 1996; 154: 1155-1158

Dr. Taylor is a research associate professor in the Department of Administrative Studies, York University, North York, Ont. Dr. Kelner is professor emerita in the Department of Behavioural Science, Centre for Studies of Aging, University of Toronto, Toronto, Ont.

This is the last in a series on genetic screening for heritable breast, ovarian and colon cancer. The previous articles appeared in the Jan. 15, Feb. 15 and Mar. 15, 1996, issues. The series arose from the work of the steering committee of the Critical Choices international symposium, Toronto, Ont., Apr. 28-30, 1995.

Paper reprints of the full text may be obtained from: Dr. Kathryn M. Taylor, Department of Administrative Studies, Atkinson College, York University, 4700 Keele St., North York ON M3J 1P3; fax 416 231-6015; ktaylor@yorku.ca

Abstract

As genetic testing for susceptibility to breast, ovarian and colon cancer becomes more readily available, physicians are faced with an increasing demand for information about inherited cancer risk. Because advances in treatment have not kept pace with advances in predictive testing, the provision of genetic counselling and testing marks a departure from the traditional role of the physician. A systematic framework is needed within which the physician's emerging role in predictive testing for heritable cancer can be delineated. The development of such a framework will require collaboration among professionals in a range of scientific disciplines, as well as the suspension of traditional assumptions about the physician's role.

Résumé

Comme les analyses génétiques de vulnérabilité au cancer du sein, de l'ovaire et du côlon deviennent plus facilement accessibles, les médecins doivent répondre à de plus en plus de demandes de renseignements sur le risque de cancer héréditaire. Comme les progrès des traitements n'ont pas suivi ceux des tests prédictifs, la prestation de conseils génétiques et de tests représente un écart par rapport au rôle habituel du médecin. Il faut un cadre systématique qui permettra de délimiter le nouveau rôle du médecin face aux tests prédictifs de dépistage du cancer héréditaire. Pour établir un tel cadre, il faudra réunir la collaboration des professionnels de toutes sortes de disciplines scientifiques, et écarter des hypothèses traditionnelles au sujet du rôle du médecin.

| CMAJ April 15, 1996 (vol 154, no 8) / JAMC le 15 avril 1996 (vol 154, no 8) |