Genetic screening A primer for primary care

• Published in: Canadian family physician 2010-04, Vol.56 (4), p.333-339
• Main Authors: Andermann, Anne, Blancquaert, Ingeborg
• Format: Article
• Language: English
• Subjects: Decision Making; Genetic Diseases, Inborn - diagnosis; Genetic Diseases, Inborn - genetics; Genetic disorders; Genetic Testing; Genetics; Guidelines as Topic; Humans; Patient Education as Topic - methods; Practice; Predictive Value of Tests; Primary care; Primary Health Care - methods; Primary Health Care - standards; Rare Diseases - epidemiology; Time Factors
• ISSN: 0008-350X; 1715-5258

To provide a primer for primary care professionals who are increasingly called upon to discuss the growing number of genetic screening services available and to help patients make informed decisions about whether to participate in genetic screening, how to interpret results, and which interventions are most appropriate. As part of a larger research program, a wide literature relating to genetic screening was reviewed. PubMed and Internet searches were conducted using broad search terms. Effort was also made to identify the gray literature. Genetic screening is a type of public health program that is systematically offered to a specified population of asymptomatic individuals with the aim of providing those identified as high risk with prevention, early treatment, or reproductive options. Ensuring an added benefit from screening, as compared with standard clinical care, and preventing unintended harms, such as undue anxiety or stigmatization, depends on the design and implementation of screening programs, including the recruitment methods, education and counseling provided, timing of screening, predictive value of tests, interventions available, and presence of oversight mechanisms and safeguards. There is therefore growing apprehension that economic interests might lead to a market-driven approach to introducing and expanding screening before program effectiveness, acceptability, and feasibility have been demonstrated. As with any medical intervention, there is a moral imperative for genetic screening to do more good than harm, not only from the perspective of individuals and families, but also for the target population and society as a whole. Primary care professionals have an important role to play in helping their patients navigate the rapidly changing terrain of genetic screening services by informing them about the benefits and risks of new genetic and genomic technologies and empowering them to make more informed choices.