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Hardy MW, Peshkin BN, Rose E, Ladd MK, Binion S, Tynan M, McBride CM, Grinzaid KA, Schwartz MD. Attitudes and interest in incorporating BRCA1/2 cancer susceptibility testing into reproductive carrier screening for Ashkenazi Jewish men and women. J Community Genet 2022; 13:281-292. [PMID: 35486291 PMCID: PMC9051789 DOI: 10.1007/s12687-022-00590-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/19/2022] [Indexed: 10/31/2022] Open
Abstract
Pathogenic variants in the BRCA1 and BRCA2 (BRCA1/2) genes are associated with elevated cancer risks in men and women. Due to a founder effect, Ashkenazi Jewish individuals are at higher risk for carrying three specific BRCA1/2 pathogenic variants. There have been recent calls for population screening in this population because many carriers do not have family histories suggestive of hereditary cancer. One approach could be to integrate optional BRCA1/2 testing into routinely offered reproductive carrier screening for recessive and X-linked disorders. However, the differing goals of these types of testing (i.e., personal health risks versus family planning) raise questions about the implications for patient education and informed consent. To this end, we aimed to determine interest, attitudes, and preferences regarding integrating such testing by electronically surveying 331 Ashkenazi Jewish participants in JScreen - a national, not-for-profit, at-home carrier screening program focused on genetic risks in Jewish communities. We found that while 41% of participants had plans to pursue BRCA1/2 testing, 93% would have opted for such testing if offered as an add-on to reproductive carrier screening. This was particularly true of those with higher perceived cancer risk and more positive attitudes toward genetic testing. With respect to preferences about delivery of this service, more than 85% of participants preferred remote (telephone, print, or web-based) genetic education rather than traditional genetic counseling. These results suggest that offering optional BRCA1/2 testing within the context of reproductive carrier screening might provide opportunities for cancer prevention without overburdening scarce genetic counseling resources.
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Affiliation(s)
- Melanie W Hardy
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Beth N Peshkin
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, 20007, USA
| | - Esther Rose
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Mary Kathleen Ladd
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, 20007, USA
| | - Savannah Binion
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, 20007, USA
| | - Mara Tynan
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, 20007, USA
| | - Colleen M McBride
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Karen A Grinzaid
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Marc D Schwartz
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, 20007, USA.
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Morgenstern-Kaplan D, Raijman-Policar J, Majzner-Aronovich S, Aradhya S, Pineda-Alvarez DE, Aguinaga M, García-Vences EE. Carrier screening in the Mexican Jewish community using a pan-ethnic expanded carrier screening NGS panel. Genet Med 2021; 24:821-830. [PMID: 34961661 DOI: 10.1016/j.gim.2021.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022] Open
Abstract
PURPOSE The Mexican Jewish community (MJC) is a previously uncharacterized, genetically isolated group composed of Ashkenazi and Sephardi-Mizrahi Jews who migrated in the early 1900s. We aimed to determine the heterozygote frequency of disease-causing variants in 302 genes in this population. METHODS We conducted a cross-sectional study of the MJC involving individuals representing Ashkenazi Jews, Sephardi-Mizrahi Jews, or mixed-ancestry Jews. We offered saliva-based preconception pan-ethnic expanded carrier screening, which examined 302 genes. We analyzed heterozygote frequencies of pathogenic/likely pathogenic variants and compared them with those in the Genome Aggregation Database (gnomAD). RESULTS We recruited 208 participants. The carrier screening results showed that 72.1% were heterozygous for at least 1 severe disease-causing variant in 1 of the genes analyzed. The most common genes with severe disease-causing variants were CFTR (16.8% of participants), MEFV (11.5%), WNT10A (6.7%), and GBA (6.7%). The allele frequencies were compared with those in the gnomAD; 85% of variant frequencies were statistically different from those found in gnomAD (P <.05). Finally, 6% of couples were at risk of having a child with a severe disorder. CONCLUSION The heterozygote frequency of at least 1 severe disease-causing variant in the MJC was 72.1%. The use of carrier screening in the MJC and other understudied populations could help parents make more informed decisions.
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Affiliation(s)
- Dan Morgenstern-Kaplan
- Centro de Investigación en Ciencias de la Salud (CICSA), Health Sciences Faculty, Anahuac University, Mexico City, Mexico.
| | - Jaime Raijman-Policar
- Centro de Investigación en Ciencias de la Salud (CICSA), Health Sciences Faculty, Anahuac University, Mexico City, Mexico
| | - Sore Majzner-Aronovich
- Centro de Investigación en Ciencias de la Salud (CICSA), Health Sciences Faculty, Anahuac University, Mexico City, Mexico
| | | | | | - Mónica Aguinaga
- Centro de Investigación en Ciencias de la Salud (CICSA), Health Sciences Faculty, Anahuac University, Mexico City, Mexico; Sexual and Reproductive Health Department, National Institute of Perinatology, Mexico City, Mexico
| | - Edna Elisa García-Vences
- Centro de Investigación en Ciencias de la Salud (CICSA), Health Sciences Faculty, Anahuac University, Mexico City, Mexico
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3
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Systematic review of outcomes in studies of reproductive genetic carrier screening: Towards development of a core outcome set. Genet Med 2021; 24:1-14. [PMID: 34906455 DOI: 10.1016/j.gim.2021.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/09/2021] [Accepted: 09/10/2021] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Current practice recommendations support the widespread implementation of reproductive genetic carrier screening (RGCS). These consensus-based recommendations highlight a research gap, with findings from current studies being insufficient to meet the standard required for more rigorous evidence-based recommendations. This systematic review assessed methodological aspects of studies on RGCS to inform the need for a core outcome set. METHODS We conducted a systematic search to identify peer-reviewed published studies offering population-based RGCS. Study designs, outcomes, and measurement methods were extracted. A narrative synthesis was conducting using an existing outcome taxonomy and criteria used in the evaluation of genetic screening programs as frameworks. RESULTS Sixty-five publications were included. We extracted 120 outcomes representing 24 outcome domains. Heterogeneity in outcome selection, measurement methods and time points of assessment was extensive. Quality appraisal raised concerns for bias. We found that reported outcomes had limited applicability to criteria used to evaluate genetic screening programs. CONCLUSION Despite a large body of literature, diverse approaches to research have limited the conclusions that can be cumulatively drawn from this body of evidence. Consensus regarding meaningful outcomes for evaluation of RGCS would be a valuable first step in working towards evidence-based practice recommendations, supporting the development of a core outcome set.
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Bean LJH, Scheuner MT, Murray MF, Biesecker LG, Green RC, Monaghan KG, Palomaki GE, Sharp RR, Trotter TL, Watson MS, Powell CM. DNA-based screening and personal health: a points to consider statement for individuals and health-care providers from the American College of Medical Genetics and Genomics (ACMG). Genet Med 2021; 23:979-988. [PMID: 33790423 DOI: 10.1038/s41436-020-01083-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 01/15/2023] Open
Affiliation(s)
- Lora J H Bean
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Maren T Scheuner
- Division of Medical Genetics, Department of Pediatrics, and Division of Hematology-Oncology, Department of Medicine, University of California San Francisco School of Medicine, San Francisco, CA, USA.,Clinical Genetics Program, San Francisco VA Health Care System, San Francisco, CA, USA
| | - Michael F Murray
- Department of Genetics, Yale School of Medicine, New Haven, CT, USA
| | - Leslie G Biesecker
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Robert C Green
- Harvard Medical School, Boston, MA, USA.,Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - Glenn E Palomaki
- Department of Pathology and Laboratory Medicine, Alpert Medical School, Brown University, Providence, RI, USA.,Women and Infants Hospital, Providence, RI, USA
| | | | - Tracy L Trotter
- San Ramon Valley Primary Care Medical Group, San Ramon, CA, USA
| | | | - Cynthia M Powell
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Division of Genetics and Metabolism, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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5
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Yip T, Grinzaid KA, Bellcross C, Moore RH, Page PZ, Hardy MW. Patients' reactions and follow-up testing decisions related to Tay-Sachs (HEXA) variants of uncertain significance results. J Genet Couns 2019; 28:738-749. [PMID: 30843643 DOI: 10.1002/jgc4.1108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/16/2019] [Accepted: 02/02/2019] [Indexed: 11/10/2022]
Abstract
JScreen is a national public health initiative based out of Emory University that provides reproductive carrier screening through an online portal and follow-up genetic counseling services. In 2014, JScreen began reporting to patients variants of uncertain significance (VUSs) in the gene that causes Tay-Sachs disease (HEXA). Genetic counseling was provided to discuss the VUS and patients were offered hexosaminidase A (HEXA) blood enzyme testing to assist with VUS reclassification. To identify patient reactions and factors influencing their follow-up testing decisions after receiving these results, we conducted a retrospective quantitative study by administering online surveys to 62 patients with HEXA VUSs. Participants who pursued enzyme testing and those who did not both experienced low levels of distress when receiving the VUS results. Perceptions of HEXA carrier status after genetic counseling, decisional conflict levels, plans to have children in the near future, time available to pursue enzyme testing, and eligibility for research were significant factors influencing decision-making to pursue or not pursue enzyme testing. Genetic counseling played an important role in helping patients understand the VUS and follow-up testing options. When discussing VUSs with patients, it would be beneficial for genetic counselors to focus on the patient's perception of the VUS, anxiety related to the uncertainty of their results, and follow-up options, when available.
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Affiliation(s)
- Tiffany Yip
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - Karen A Grinzaid
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - Cecelia Bellcross
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - Reneé H Moore
- Department of Public Health, Emory University, Atlanta, Georgia
| | - Patricia Z Page
- Department of Clinical and Diagnostic Sciences, University of Alabama at Birmingham School of Health Professions, Birmingham, Alabama
| | - Melanie W Hardy
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
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6
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Hardy MW, Kener HJ, Grinzaid KA. Implementation of a Carrier Screening Program in a High-Risk Undergraduate Student Population Using Digital Marketing, Online Education, and Telehealth. Public Health Genomics 2018; 21:67-76. [PMID: 30408784 DOI: 10.1159/000493971] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 09/23/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Access to preconception carrier screening, which provides at-risk couples with more reproductive options, is critically important. To address this need in the Jewish community, genetic counselors at Emory University launched JScreen (www.jscreen.org), a national online genetic disease education and carrier screening program. To reach the preconception demographic, JScreen initiated a study evaluating the impact of marketing and education on knowledge and screening activity on college campuses. METHODS Students at 10 universities were targeted with a marketing campaign designed for this initiative. Those who elected screening were provided pre-test video education designed for the study. Success was assessed through enrollment in testing, comparison of pre- and post-education knowledge quizzes, and patient satisfaction surveys evaluating genetic counseling and the JScreen process. RESULTS A total of 1,794 participants were enrolled. Over 99% of those screened were not pregnant. Knowledge quiz scores improved significantly post-education, and patient satisfaction was over 98%. CONCLUSIONS Findings suggested that the use of targeted marketing helped promote preconception screening in this population. The study demonstrated that video education was effective in educating participants about benefits and limitations of testing. Also, the use of telehealth technology facilitated access to professional genetic counseling services. This study serves as a model for future public health initiatives.
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Affiliation(s)
| | - Hillary J Kener
- Department of Human Genetics, Emory University, Atlanta, Georgia, USA
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Gordon ES, Babu D, Laney DA. The future is now: Technology's impact on the practice of genetic counseling. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2018. [DOI: 10.1002/ajmg.c.31599] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Dawn A. Laney
- Department of Human GeneticsEmory School of MedicineDecatur Georgia
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8
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Stoll K, Kubendran S, Cohen SA. The past, present and future of service delivery in genetic counseling: Keeping up in the era of precision medicine. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2018. [DOI: 10.1002/ajmg.c.31602] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Katie Stoll
- Genetic Support FoundationOlympia Washington
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9
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Chokoshvili D, Borry P, Vears DF. A systematic analysis of online marketing materials used by providers of expanded carrier screening. Genet Med 2017; 20:976-984. [PMID: 29240075 DOI: 10.1038/gim.2017.222] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/03/2017] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Expanded carrier screening (ECS) for a large number of recessive disorders is available to prospective parents through commercial providers. This study aimed to analyze the content of marketing materials on ECS providers' websites. METHODS To identify providers of ECS tests, we undertook a comprehensive online search, reviewed recent academic literature on commercial carrier screening, and consulted with colleagues familiar with the current ECS landscape. The identified websites were archived in April 2017, and inductive content analysis was performed on website text, brochures and educational materials, and video transcripts. RESULTS We identified 18 ECS providers, including 16 commercial genetic testing companies. Providers typically described ECS as an important family planning tool. The content differed in both the tone used to promote ECS and the accuracy and completeness of the test information provided. We found that most providers offered complimentary genetic counseling to their consumers, although this was often optional, limited to the posttest context, and, in some cases, appeared to be available only to test-positive individuals. CONCLUSION The quality of ECS providers' websites could be improved by offering more complete and accurate information about ECS and their tests. Providers should also ensure that all carrier couples receive posttest genetic counseling to inform their subsequent reproductive decision making.
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Affiliation(s)
- Davit Chokoshvili
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Pascal Borry
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Danya F Vears
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
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11
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Fan CW, Castonguay L, Rummell S, Lévesque S, Mitchell JJ, Sillon G. Online Module for Carrier Screening in Ashkenazi Jewish Individuals Compared with In-Person Genetics Education: A Randomized Controlled Trial. J Genet Couns 2017; 27:426-438. [PMID: 28791521 DOI: 10.1007/s10897-017-0133-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 07/18/2017] [Indexed: 11/29/2022]
Abstract
To increase accessibility to genetics services for low-urgency patients seeking Ashkenazi Jewish (AJ) carrier screening, we designed an interactive computer (IC) module that provides pre-test genetics education and allows genetics professionals to order the test without meeting the patients beforehand. We compared this module with in-person genetic counseling (GC) using a randomized trial. AJ individuals were randomized to undergo genetics education via the IC module (n = 26) or GC (n = 28). We compared post-interventional genetics knowledge, perceived genetic risk, and anxiety between the two groups, after accounting for pre-interventional scores, using ANCOVA. Wilcoxon Rank-Sum test was used to compare post-interventional satisfaction. Post-interventional genetics knowledge, risk perception, or anxiety were not significantly different between the two groups after accounting for baseline scores (p = 0.50-0.54), although the data are inconclusive regarding the module's non-inferiority at a 5% margin. Post-intervention satisfaction scores were generally higher in the GC group than the IC module group. Our IC module has the potential to improve access to clinical genetics services for patients and staff, but it is not suitable for all AJ patients and cannot completely replace the benefits of in-person consultations.
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Affiliation(s)
- Chia Wei Fan
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Lysanne Castonguay
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sonja Rummell
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sébastien Lévesque
- Department of Pediatrics, Division of Medical Genetics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - John J Mitchell
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.,Department of Medical Genetics, McGill University Health Center, 1001 boul. Décarie, Room A04.3140, Montreal, Quebec, H4A 3J1, Canada.,Department of Endocrinology and Metabolism, McGill University Health Center, Montreal, Quebec, Canada
| | - Guillaume Sillon
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. .,Department of Medical Genetics, McGill University Health Center, 1001 boul. Décarie, Room A04.3140, Montreal, Quebec, H4A 3J1, Canada.
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12
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Whole-Exome Sequencing Identifies a Novel Homozygous Frameshift Mutation in the MTMR2 Gene as a Causative Mutation in a Patient with Charcot-Marie-Tooth Disease Type 4B1. Mol Neurobiol 2017; 55:3546-3550. [DOI: 10.1007/s12035-017-0588-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 04/28/2017] [Indexed: 01/08/2023]
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13
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Hardy MW, Grinzaid KA. Benefits and Challenges of Telemedicine: the JScreen Program Experience. CURRENT GENETIC MEDICINE REPORTS 2017. [DOI: 10.1007/s40142-017-0121-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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14
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Wiesman C, Rose E, Grant A, Zimilover A, Klugman S, Schreiber-Agus N. Experiences from a pilot program bringing BRCA1/2 genetic screening to theUS Ashkenazi Jewish population. Genet Med 2016; 19:529-536. [PMID: 27735926 DOI: 10.1038/gim.2016.154] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 08/17/2016] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The notion of offering population-based screening to the Ashkenazi Jewish (AJ) population for the BRCA1/2 founder mutations continues to gain support. A program called the BRCAcommunity initiative was designed to identify the benefits and barriers associated with implementing this screening in a clinical setting. METHODS Interested AJ individuals were stratified into high-risk (HR) and low-risk (LR) groups based on self-reported cancer histories. Those at HR were offered traditional genetic counseling/testing; those at LR were offered group genetic counseling and subsidized AJ BRCA founder mutation testing. RESULTS During the pilot year, 62% of initial registrants and 53% of ultimate study participants were classified into the HR group. Among the 101 HR and 88 LR study participants, 8 and 2 BRCA carriers were identified, respectively. The LR carriers would have been missed by current mechanisms. Survey responses provided insight into the motivations and fears associated with pursuing testing, the efficacy of the initiative design, and challenges that exist on multiple levels, including the community, health-care providers, and insurance coverage. CONCLUSION Although the medical value of identifying presymptomatic BRCA carriers in Ashkenazi Jews is evident, further measures need to be taken before this effort can be accomplished on a large scale.Genet Med advance online publication 13 October 2016.
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Affiliation(s)
- Chana Wiesman
- Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.,Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Esther Rose
- Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.,Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Allison Grant
- Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Adam Zimilover
- Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Susan Klugman
- Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.,Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Nicole Schreiber-Agus
- Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.,Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.,Department of Genetics, Albert Einstein College of Medicine, Bronx, New York, USA
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Plantinga M, Birnie E, Abbott KM, Sinke RJ, Lucassen AM, Schuurmans J, Kaplan S, Verkerk MA, Ranchor AV, van Langen IM. Population-based preconception carrier screening: how potential users from the general population view a test for 50 serious diseases. Eur J Hum Genet 2016; 24:1417-23. [PMID: 27165008 PMCID: PMC5027688 DOI: 10.1038/ejhg.2016.43] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 02/17/2016] [Accepted: 04/07/2016] [Indexed: 11/09/2022] Open
Abstract
With the increased international focus on personalized health care and preventive medicine, next-generation sequencing (NGS) has substantially expanded the options for carrier screening of serious, recessively inherited diseases. NGS screening tests not only offer reproductive options not previously available to couples, but they may also ultimately reduce the number of children born with devastating disorders. To date, preconception carrier screening (PCS) has largely targeted single diseases such as cystic fibrosis, but NGS allows the testing of many genes or diseases simultaneously. We have developed an expanded NGS PCS test for couples; simultaneously it covers 50 very serious, early-onset, autosomal recessive diseases that are untreatable. This is the first, noncommercial, population-based, expanded PCS test to be offered prospectively to couples in a health-care setting in Europe. So far, little is known about how potential users view such a PCS test. We therefore performed an online survey in 2014 among 500 people from the target population in the Netherlands. We enquired about their intention to take an expanded PCS test if one was offered, and through which provider they would like to see it offered. One-third of the respondents said they would take such a test were it to be offered. The majority (44%) preferred the test to be offered via their general practitioner (GP) and 58% would be willing to pay for the test, with a median cost of [euro ]75. Our next step is to perform an implementation study in which this PCS test will be provided via selected GPs in the Northern Netherlands.
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Affiliation(s)
- Mirjam Plantinga
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erwin Birnie
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Kristin M Abbott
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Richard J Sinke
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anneke M Lucassen
- Clinical Ethics and Law, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Juliette Schuurmans
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Seyma Kaplan
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marian A Verkerk
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Adelita V Ranchor
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Irene M van Langen
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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16
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Foroud T, Smith D, Jackson J, Verbrugge J, Halter C, Wetherill L, Sims K, Xin W, Arnedo V, Lasch S, Marek K. Novel recruitment strategy to enrich for LRRK2 mutation carriers. Mol Genet Genomic Med 2015; 3:404-12. [PMID: 26436106 PMCID: PMC4585448 DOI: 10.1002/mgg3.151] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 03/27/2015] [Accepted: 03/31/2015] [Indexed: 11/29/2022] Open
Abstract
The LRRK2 G2019S mutation is found at higher frequency among Parkinson disease (PD) patients of Ashkenazi Jewish (AJ) ancestry. This study was designed to test whether an internet-based approach could be an effective approach to screen and identify mutation carriers. Individuals with and without PD of AJ ancestry were recruited and consented through an internet-based study website. An algorithm was applied to a series of screening questions to identify individuals at increased risk to carry the LRRK2 G2019S mutation. About 1000 individuals completed the initial screening. Around 741 qualified for mutation testing and 650 were tested. Seventy-two individuals carried at least one LRRK2 G2019S mutation; 38 with PD (12.5%) and 34 without (10.1%). Among the AJ PD participants, each affected first-degree relative increased the likelihood the individual was LRRK2+ [OR = 4.7; 95% confidence interval = (2.4-9.0)]. The same was not observed among the unaffected AJ subjects (P = 0.11). An internet-based approach successfully screened large numbers of individuals to identify those with risk factors increasing the likelihood that they carried a LRRK2 G2019S mutation. A similar approach could be implemented in other disorders to identify individuals for clinical trials, biomarker analyses and other types of research studies.
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Affiliation(s)
- Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of MedicineIndianapolis, Indiana, 46202
| | - Danielle Smith
- Department of Medical and Molecular Genetics, Indiana University School of MedicineIndianapolis, Indiana, 46202
| | - Jacqueline Jackson
- Department of Medical and Molecular Genetics, Indiana University School of MedicineIndianapolis, Indiana, 46202
| | - Jennifer Verbrugge
- Department of Medical and Molecular Genetics, Indiana University School of MedicineIndianapolis, Indiana, 46202
| | - Cheryl Halter
- Department of Medical and Molecular Genetics, Indiana University School of MedicineIndianapolis, Indiana, 46202
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of MedicineIndianapolis, Indiana, 46202
| | - Katherine Sims
- Department of Neurology, Center for Human Genetic Research, Massachusetts General HospitalBoston, Massachusetts, 02114
| | - Winnie Xin
- Department of Neurology, Center for Human Genetic Research, Massachusetts General HospitalBoston, Massachusetts, 02114
| | | | - Shirley Lasch
- Institute for Neurodegenerative DisordersNew Haven, Connecticut, 06510
| | - Kenneth Marek
- Institute for Neurodegenerative DisordersNew Haven, Connecticut, 06510
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Trepanier AM, Cohen SA, Allain DC. Thinking Differently About Genetic Counseling Service Delivery. CURRENT GENETIC MEDICINE REPORTS 2015. [DOI: 10.1007/s40142-015-0069-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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