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Identification of Germline Variants in Patients with Hereditary Cancer Syndromes in Northeast Mexico. Genes (Basel) 2023; 14:genes14020341. [PMID: 36833268 PMCID: PMC9957276 DOI: 10.3390/genes14020341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
Hereditary cancer syndromes (HCS) are genetic diseases with an increased risk of developing cancer. This research describes the implementation of a cancer prevention model, genetic counseling, and germline variants testing in an oncologic center in Mexico. A total of 315 patients received genetic counseling, genetic testing was offered, and 205 individuals were tested for HCS. In 6 years, 131 (63.90%) probands and 74 (36.09%) relatives were tested. Among the probands, we found that 85 (63.9%) had at least one germline variant. We identified founder mutations in BRCA1 and a novel variant in APC that led to the creation of an in-house detection process for the whole family. The most frequent syndrome was hereditary breast and ovarian cancer syndrome (HBOC) (41 cases with BRCA1 germline variants in most of the cases), followed by eight cases of hereditary non-polyposic cancer syndrome (HNPCC or Lynch syndrome) (with MLH1 as the primarily responsible gene), and other high cancer risk syndromes. Genetic counseling in HCS is still a global challenge. Multigene panels are an essential tool to detect the variants frequency. Our program has a high detection rate of probands with HCS and pathogenic variants (40%), compared with other reports that detect 10% in other populations.
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2
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Best S, Vidic N, An K, Collins F, White SM. A systematic review of geographical inequities for accessing clinical genomic and genetic services for non-cancer related rare disease. Eur J Hum Genet 2022; 30:645-652. [PMID: 35046503 DOI: 10.1038/s41431-021-01022-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/28/2021] [Accepted: 12/02/2021] [Indexed: 11/09/2022] Open
Abstract
Place plays a significant role in our health. As genetic/genomic services evolve and are increasingly seen as mainstream, especially within the field of rare disease, it is important to ensure that where one lives does not impede access to genetic/genomic services. Our aim was to identify barriers and enablers of geographical equity in accessing clinical genomic or genetic services. We undertook a systematic review searching for articles relating to geographical access to genetic/genomic services for rare disease. Searching the databases Medline, EMBASE and PubMed returned 1803 papers. Screening led to the inclusion of 20 articles for data extraction. Using inductive thematic analysis, we identified four themes (i) Current service model design, (ii) Logistical issues facing clinicians and communities, (iii) Workforce capacity and capability and iv) Rural culture and consumer beliefs. Several themes were common to both rural and urban communities. However, many themes were exacerbated for rural populations due to a lack of clinician access to/relationships with genetic specialist staff, the need to provide more generalist services and a lack of genetic/genomic knowledge and skill. Additional barriers included long standing systemic service designs that are not fit for purpose due to historically ad hoc approaches to delivery of care. There were calls for needs assessments to clarify community needs. Enablers of geographically equitable care included the uptake of new innovative models of care and a call to raise both community and clinician knowledge and awareness to demystify the clinical offer from genetics/genomics services.
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Affiliation(s)
- Stephanie Best
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia. .,Australian Genomics, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | - Nada Vidic
- Australian Genomics, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Kim An
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Felicity Collins
- Clinical Genetics Service, Institute of Precision Medicine and Bioinformatics, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Divisions of Genomic Medicine, Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia
| | - Susan M White
- Australian Genomics, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.,Victorian Clinical Genetics Services, Melbourne, VIC, Australia
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3
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Fernandez-Garza LE, Dominguez-Vigil IG, Garza-Martinez J, Valdez-Aparicio EA, Barrera-Barrera SA, Barrera-Saldana HA. Personalized Medicine in Ovarian Cancer: A Perspective From Mexico. World J Oncol 2021; 12:85-92. [PMID: 34349852 PMCID: PMC8297048 DOI: 10.14740/wjon1383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/26/2021] [Indexed: 11/15/2022] Open
Abstract
Ovarian cancer (OC) represents a serious health problem worldwide. In Mexico, most OC patients are detected at late stages, consequently making OC one of the leading causes of death in women after reaching puberty. Personalized medicine (PM) provides an individualized therapeutic opportunity for treating each patient relying on “omic” tools to match the correct drug with the specific pathogenic genomic signature. PM can help predict the best therapeutic option for each affected woman suffering from OC. In recent years, Mexico has made contributions to the PM of OC; however, it still has a long way to go for its full implementation in the country’s health system.
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Affiliation(s)
- Luis E Fernandez-Garza
- Innbiogem SC/Vitagenesis SA at National Laboratory for Services of Research, Development, and Innovation for the Pharma and Biotech Industries (LANSEIDI) of CONACyT Vitaxentrum Group, Monterrey, Nuevo Leon, Mexico
| | - Irma G Dominguez-Vigil
- Laboratory for Translational Research, Rudy L. Ruggles Biomedical Research Institute, Nuvance Health, Danbury, CT, USA
| | | | - Erick A Valdez-Aparicio
- Innbiogem SC/Vitagenesis SA at National Laboratory for Services of Research, Development, and Innovation for the Pharma and Biotech Industries (LANSEIDI) of CONACyT Vitaxentrum Group, Monterrey, Nuevo Leon, Mexico
| | | | - Hugo A Barrera-Saldana
- Innbiogem SC/Vitagenesis SA at National Laboratory for Services of Research, Development, and Innovation for the Pharma and Biotech Industries (LANSEIDI) of CONACyT Vitaxentrum Group, Monterrey, Nuevo Leon, Mexico.,Center for Genomic Biotechnology of National Polytechnic Institute, Reynosa, Tamaulipas, Mexico
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4
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Serra G, Memo L, Coscia A, Giuffré M, Iuculano A, Lanna M, Valentini D, Contardi A, Filippeschi S, Frusca T, Mosca F, Ramenghi LA, Romano C, Scopinaro A, Villani A, Zampino G, Corsello G. Recommendations for neonatologists and pediatricians working in first level birthing centers on the first communication of genetic disease and malformation syndrome diagnosis: consensus issued by 6 Italian scientific societies and 4 parents' associations. Ital J Pediatr 2021; 47:94. [PMID: 33874990 PMCID: PMC8054427 DOI: 10.1186/s13052-021-01044-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/07/2021] [Indexed: 12/30/2022] Open
Abstract
Background Genetic diseases are chronic conditions with relevant impact on the lives of patients and their families. In USA and Europe it is estimated a prevalence of 60 million affected subjects, 75% of whom are in developmental age. A significant number of newborns are admitted in the Neonatal Intensive Care Units (NICU) for reasons different from prematurity, although the prevalence of those with genetic diseases is unknown. It is, then, common for the neonatologist to start a diagnostic process on suspicion of a genetic disease or malformation syndrome, or to make and communicate these diagnoses. Many surveys showed that the degree of parental satisfaction with the methods of communication of diagnosis is low. Poor communication may have short and long-term negative effects on health and psychological and social development of the child and his family. We draw up recommendations on this issue, shared by 6 Italian Scientific Societies and 4 Parents’ Associations, aimed at making the neonatologist’s task easier at the difficult time of communication to parents of a genetic disease/malformation syndrome diagnosis for their child. Methods We used the method of the consensus paper. A multidisciplinary panel of experts was first established, based on the clinical and scientific sharing of the thematic area of present recommendations. They were suggested by the Boards of the six Scientific Societies that joined the initiative: Italian Societies of Pediatrics, Neonatology, Human Genetics, Perinatal Medicine, Obstetric and Gynecological Ultrasound and Biophysical Methodologies, and Pediatric Genetic Diseases and Congenital Disabilities. To obtain a deeper and global vision of the communication process, and to reach a better clinical management of patients and their families, representatives of four Parents’ Associations were also recruited: Italian Association of Down People, Cornelia de Lange National Volunteer Association, Italian Federation of Rare Diseases, and Williams Syndrome People Association. They worked from September 2019 to November 2020 to achieve a consensus on the recommendations for the communication of a new diagnosis of genetic disease. Results The consensus of experts drafted a final document defining the recommendations, for the neonatologist and/or the pediatrician working in a fist level birthing center, on the first communication of genetic disease or malformation syndrome diagnosis. Although there is no universal communication technique to make the informative process effective, we tried to identify a few relevant strategic principles that the neonatologist/pediatrician may use in the relationship with the family. We also summarized basic principles and significant aspects relating to the modalities of interaction with families in a table, in order to create an easy tool for the neonatologist to be applied in the daily care practice. We finally obtained an intersociety document, now published on the websites of the Scientific Societies involved. Conclusions The neonatologist/pediatrician is often the first to observe complex syndromic pictures, not always identified before birth, although today more frequently prenatally diagnosed. It is necessary for him to know the aspects of genetic diseases related to communication and bioethics, as well as the biological and clinical ones, which together outline the cornerstones of the multidisciplinary care of these patients. This consensus provide practical recommendations on how to make the first communication of a genetic disease /malformation syndrome diagnosis. The proposed goal is to make easier the informative process, and to implement the best practices in the relationship with the family. A better doctor-patient/family interaction may improve health outcomes of the child and his family, as well as reduce legal disputes with parents and the phenomenon of defensive medicine.
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Affiliation(s)
- Gregorio Serra
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
| | - Luigi Memo
- Clinical Genetics Outpatient Service, Neonatology and Neonatal Intensive Care Unit, San Bortolo Hospital, Vicenza, Italy
| | - Alessandra Coscia
- University Neonatology Unit, AOU Città della Salute e della Scienza, Turin, Italy
| | - Mario Giuffré
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Ambra Iuculano
- Unit of Prenatal and Preimplantation Diagnosis, Thalassaemic Hospital, AO Brotzu, Cagliari, Italy
| | - Mariano Lanna
- Unit of Obstetrics and Gynecology, Prenatal Diagnosis and Fetal Therapy "U. Nicolini", Buzzi Hospital, ASST FBF Sacco, Milan, Italy
| | - Diletta Valentini
- Unit of General Pediatrics, Emergency and Acceptance Department, Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Anna Contardi
- Coordinator of the Italian Association of Down People, Rome, Italy
| | - Sauro Filippeschi
- President of the Italian National Association of Volunteers Cornelia de Lange, Pesaro, Italy
| | - Tiziana Frusca
- President of the Italian Society of Obstetric and Gynecological Ultrasound and Biophysical Methodologies, Parma, Italy
| | - Fabio Mosca
- President of the Italian Society of Neonatology, Milan, Italy
| | - Luca A Ramenghi
- President of the Italian Society of Perinatal Medicine, Genoa, Italy
| | - Corrado Romano
- Coordinator of the Clinical Genetics Study Group of the Italian Society of Human Genetics, Troina, EN, Italy
| | - Annalisa Scopinaro
- President of Italian Federation of Rare Diseases and of Williams Syndrome People Association, Rome, Italy
| | | | - Giuseppe Zampino
- President of the Italian Society of Pediatric Genetic Diseases and Congenital Disabilities, Rome, Italy
| | - Giovanni Corsello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
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5
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Bevan A, Saragoussi D, Sayegh L, Ringo M, Kearney F. Genetic Testing in Natural History Studies: A Review of the Regulatory and Legal Landscape. Public Health Genomics 2021; 24:75-88. [PMID: 33756465 DOI: 10.1159/000514208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 12/31/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Natural history (NH) studies, using observational methods, are common in rare and orphan diseases (80% of which have a genetic component). There is profound interest in identifying genetic mutations driving these diseases in these studies to support the formulation of targeted precision medicines. The global regulatory classification of NH studies with novel molecular biomarker collection has not been clearly delineated, presenting researchers with the challenge of determining how these studies are classified and regulated across multiple geographies. OBJECTIVE The aim of this investigation was to conduct a review of regulations related to NH studies and genetic testing to elucidate regulatory pathways to inform clinical researchers in the field. METHODS Regulatory provisions for NH studies and genetic testing were obtained from Pharmaceutical Product Development (PPD)'s propriety regulatory intelligence database and by surveying the company's country-specific regulatory experts. A literature search was conducted in the Google Scholar search engine and PubMed for supplementary information. RESULTS Nineteen countries were evaluated; 37% classified NH studies with biomarker collection as noninterventional and 26% required regulatory approval (increasing to 47% when molecular biomarker testing was introduced). No regulatory provisions for genetic testing could be identified in 32% of countries, and 58% did not have binding requirements for genetic counseling. CONCLUSION Lack of harmonization of regulations governing NH studies with molecular biomarker collection contributes to the operational complexity of conducting multinational studies in orphan and rare diseases. A set of harmonized international guidelines for these studies would improve efficiency, and this may be on the horizon with the recent adaption of International Conference on Harmonisation (ICH) guideline E18.
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Affiliation(s)
- Andrew Bevan
- Peri- and Post-Approval Studies, Evidera, London, United Kingdom
| | | | - Laura Sayegh
- Peri- and Post-Approval Studies, Evidera, London, United Kingdom
| | - Moira Ringo
- Value and Development Consulting, Evidera, Bethesda, Maryland, USA
| | - Fiona Kearney
- Peri- and Post-Approval Studies, Evidera, London, United Kingdom
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Abstract
Neurodevelopmental disorders are the most prevalent chronic medical conditions encountered in pediatric primary care. In addition to identifying appropriate descriptive diagnoses and guiding families to evidence-based treatments and supports, comprehensive care for individuals with neurodevelopmental disorders includes a search for an underlying etiologic diagnosis, primarily through a genetic evaluation. Identification of an underlying genetic etiology can inform prognosis, clarify recurrence risk, shape clinical management, and direct patients and families to condition-specific resources and supports. Here we review the utility of genetic testing in patients with neurodevelopmental disorders and describe the three major testing modalities and their yields - chromosomal microarray, exome sequencing (with/without copy number variant calling), and FMR1 CGG repeat analysis for fragile X syndrome. Given the diagnostic yield of genetic testing and the potential for clinical and personal utility, there is consensus that genetic testing should be offered to all patients with global developmental delay, intellectual disability, and/or autism spectrum disorder. Despite this recommendation, data suggest that a minority of children with autism spectrum disorder and intellectual disability have undergone genetic testing. To address this gap in care, we describe a structured but flexible approach to facilitate integration of genetic testing into clinical practice across pediatric specialties and discuss future considerations for genetic testing in neurodevelopmental disorders to prepare pediatric providers to care for patients with such diagnoses today and tomorrow.
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Affiliation(s)
- Juliann M. Savatt
- Autism & Developmental Medicine Institute, Geisinger, Danville, PA, United States
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7
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Ibarra-González I, Fernández-Lainez C, Guillén-López S, López-Mejía L, Belmont-Martínez L, Nieto-Carrillo RI, Vela-Amieva M. Importance of Studying Older Siblings of Patients Identified by Newborn Screening: a Single-Center Experience in Mexico. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2021. [DOI: 10.1590/2326-4594-jiems-2021-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | - Sara Guillén-López
- Instituto Nacional de Pediatría, Laboratorio de Errores Innatos del Metabolismo y Tamiz, México
| | - Lizbeth López-Mejía
- Instituto Nacional de Pediatría, Laboratorio de Errores Innatos del Metabolismo y Tamiz, México
| | | | | | - Marcela Vela-Amieva
- Instituto Nacional de Pediatría, Laboratorio de Errores Innatos del Metabolismo y Tamiz, México
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8
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Mena R, Mendoza E, Gomez Peña M, Valencia CA, Ullah E, Hufnagel RB, Prada CE. An international telemedicine program for diagnosis of genetic disorders: Partnership of pediatrician and geneticist. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2020; 184:996-1008. [PMID: 33219631 DOI: 10.1002/ajmg.c.31859] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 11/12/2022]
Abstract
There is a shortage of genetics providers worldwide and access is limited to large academic centers. Telemedicine programs can facilitate access to genetic services to patients living in remote locations. The goal of this study was to improve access to genetic services in the Dominican Republic by creating a partnership model between a pediatrician and geneticist. This approach has been used within the United States but not in the setting of two different countries, healthcare system, and cultures. Patients were referred to the Centro de Obstetricia y Ginecologia program if a syndromic or genetic etiology was suspected by their local provider. Pediatrician first evaluated all patients prior to telemedicine appointment to review family and medical history. All genetic visits were scheduled within 2 weeks of referral in collaboration with telehealth program at Cincinnati Children's Hospital Medical Center. A total of 66 individuals were evaluated during a period of 5 years. Fifty-seven individuals underwent genetic studies, and a molecular diagnosis was made in 39 individuals. Exome sequencing was the most common first line test when differential diagnosis was broad (n = 40). The most common inheritance was autosomal recessive in 15 individuals, followed by 13 individuals with autosomal dominant disorders, 7 individuals X-linked disorders, and 4 individuals with chromosomal abnormalities. This study provides data to support utility of geneticist and pediatrician partnership to provide outreach telemedicine diagnostics and management services for rare diseases in an international setting.
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Affiliation(s)
- Rafael Mena
- Neonatal Intensive Care Unit, Centro de Obstetricia y Ginecologia, Santo Domingo, Dominican Republic.,Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Esperanza Mendoza
- Neonatal Intensive Care Unit, Centro de Obstetricia y Ginecologia, Santo Domingo, Dominican Republic
| | | | - C Alexander Valencia
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Ehsan Ullah
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Robert B Hufnagel
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Carlos E Prada
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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9
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Neogi A, Kumar J, Guan Y, Parani M. Genetic counseling education at the undergraduate level: An outreach initiative to promote professional recruitment and support workforce development. J Genet Couns 2020; 29:234-242. [PMID: 32227571 DOI: 10.1002/jgc4.1253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 02/22/2020] [Accepted: 02/24/2020] [Indexed: 11/12/2022]
Abstract
As in many other countries, the field of genetic counseling is in its initial stages of development in India, where there are efforts to streamline the profession and to implement graduate-level training programs. We implemented an elective course on genetic counseling at the undergraduate level in a private university in India to assess students' interest, to provide early exposure for students interested in pursuing the career, and to aid recruitment. To assess satisfaction with the course and recruitment outcomes, we sent a course evaluation survey to 332 students and received 134 responses. Familiarity with genetic counseling topics increased significantly after completing the course. Of the 42 respondents who reported they were planning to pursue formal genetic counseling training, 21% (n = 9/42) became interested in the profession as a result of taking this course. Survey respondents who were prospective applicants to genetic counseling training programs referred mostly to the websites of the National Society of Genetic Counselors and the American Board of Genetic Counseling for information on genetic counseling and training. Barriers to entry into the field included lack of shadowing opportunities, inadequate coursework, and limited opportunities to interact with practicing genetic counselors. Respondents stated that additional case studies as well as observation of patient interactions would elucidate the role of a genetic counselor and help define the scope of the practice in India and other countries. Overall, genetic counseling education at the undergraduate level is a scalable way to improve understanding of genetic counseling topics, increase professional interest in the field, and support workforce development.
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Affiliation(s)
- Arpita Neogi
- Department of Genetic Engineering, SRM University, Chennai, India.,International Special Interest Group, National Society of Genetic Counselors, Chicago, IL, USA
| | - Jeevan Kumar
- Department of Genetic Engineering, SRM University, Chennai, India
| | - Yue Guan
- International Special Interest Group, National Society of Genetic Counselors, Chicago, IL, USA.,Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Madasamy Parani
- Department of Genetic Engineering, SRM University, Chennai, India
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10
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Padilla-Raygoza N, Monroy-Torres R, Sandoval-Salazar C, Vera-Becerra LE, Patiño-López ME, de Lourdes García-Campos M, Campos VB, del Carmen Ortega Jiménez M, del Carmen Delgado-Sandoval S, Ramírez-Gómez XS, Jimenez-García SN, Lemus HLL. Cancer prevention programmes in Mexico: are we doing enough? Ecancermedicalscience 2020; 14:997. [PMID: 32153652 PMCID: PMC7032937 DOI: 10.3332/ecancer.2020.997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Indexed: 12/20/2022] Open
Abstract
Cancer has increased in all the countries of the world and Mexico is no exception. The recognised risk factors for the main types of cancer are reviewed and searched through the Mexican government web pages and cancer prevention programmes to tackle the risk factors in the population. The Mexican government, a member of the World Health Organization, shows that the main approach is an early diagnosis rather than prevention, forgetting that an ounce of prevention is better than a pound of cure. Effective public programmes should be promoted to reduce preventable risk factors in the population (smoking, nutrition, obesity, diet, environmental toxicity, sedentary lifestyle) and control the non-preventable factors (genetics) if we really want to control the incidence of different types of cancer.
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Affiliation(s)
| | - Rebeca Monroy-Torres
- Laboratory of Nutrition and Safety Food, Department of Medicine and Nutrition, Division of Health Sciences, Campus Leon, University of Guanajuato, León CP 37670, Mexico
| | - Cuauhtémoc Sandoval-Salazar
- Department of Nursing and Obstetrics, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Luz Elvia Vera-Becerra
- Department of Medicine and Nutrition, Division of Health Sciences, Campus Leon, University of Guanajuato, León CP 37670, Mexico
| | - María Esther Patiño-López
- Department of Clinical Nursing, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - María de Lourdes García-Campos
- Department of Clinical Nursing, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Vicente Beltrán Campos
- Department of Clinical Nursing, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Mayra del Carmen Ortega Jiménez
- Department of Nursing and Obstetrics, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Silvia del Carmen Delgado-Sandoval
- Department of Nursing and Obstetrics, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Xóchitl Sofía Ramírez-Gómez
- Department of Clinical Nursing, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Sandra Neli Jimenez-García
- Department of Clinical Nursing, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Hilda Lissette López- Lemus
- Department of Nursing and Obstetrics, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
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11
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Bucio D, Ormond KE, Hernandez D, Bustamante CD, Lopez Pineda A. A genetic counseling needs assessment of Mexico. Mol Genet Genomic Med 2019; 7:e668. [PMID: 30938092 PMCID: PMC6503023 DOI: 10.1002/mgg3.668] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/03/2019] [Accepted: 02/11/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND While genetic counseling has expanded globally, Mexico has not adopted it as a separate profession. Given the rapid expansion of genetic and genomic services, understanding the current genetic counseling landscape in Mexico is crucial to improving healthcare outcomes. METHODS Our needs assessment strategy has two components. First, we gathered quantitative data about genetics education and medical geneticists' geographic distribution through an exhaustive compilation of available information across several medical schools and public databases. Second, we conducted semi-structured interviews of 19 key-informants from 10 Mexican states remotely with digital recording and transcription. RESULTS Across 32 states, ~54% of enrolled medical students receive no medical genetics training, and only Mexico City averages at least one medical geneticist per 100,000 people. Barriers to genetic counseling services include: geographic distribution of medical geneticists, lack of access to diagnostic tools, patient health literacy and cultural beliefs, and education in medical genetics/genetic counseling. Participants reported generally positive attitudes towards a genetic counseling profession; concerns regarding a current shortage of available jobs for medical geneticists persisted. CONCLUSION To create a foundation that can support a genetic counseling profession in Mexico, the clinical significance of medical genetics must be promoted nationwide. Potential approaches include: requiring medical genetics coursework, developing community genetics services, and increasing jobs for medical geneticists.
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Affiliation(s)
- Daiana Bucio
- Department of Genetics, School of Medicine, Stanford University, Stanford, California.,Department of Clinical Genetics and Genomics, Roy and Patricia Disney Family Cancer Center, Providence Saint Joseph Medical Center, Burbank, California
| | - Kelly E Ormond
- Department of Genetics, School of Medicine, Stanford University, Stanford, California.,Stanford Center for Biomedical Ethics, School of Medicine, Stanford University, Stanford, California
| | - Daisy Hernandez
- Department of Genetics, School of Medicine, Stanford University, Stanford, California.,Department of Pediatric Genetics, Loma Linda University Health, San Bernardino, California
| | - Carlos D Bustamante
- Department of Genetics, School of Medicine, Stanford University, Stanford, California.,Department of Biomedical Data Science, School of Medicine, Stanford University, Stanford, California.,Chan Zuckerberg Biohub, San Francisco, California
| | - Arturo Lopez Pineda
- Department of Biomedical Data Science, School of Medicine, Stanford University, Stanford, California
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