Practice Considerations in Providing Cancer Risk Assessment and Genetic Testing in Women's Health

Integrating hereditary breast and ovarian cancer genetic counselling and testing into mainstream clinical practice: Legal and ethical challenges

Health professionals not specialized in genetics are expected to take an increasing role in genetic services delivery. This article aims to identify legal and ethical challenges related to a collaborative oncogenetics service model, where non-genetic health professionals provide genetic services to patients. Through a scoping literature review, we identified issues to the provision of hereditary breast and ovarian cancer, or other hereditary adult cancers, genetic testing under this model. Concerns that arose in the literature were informed consent, lack of adherence to best practice guidelines, lack of education of non-genetic health professionals on the provision of genetic services, psychological impacts of genetic testing, continuity of care, the complexity of genetic test results, confidentiality, risks of medical mismanagement, and the associated medical responsibility liabilities. Despite these challenges, there is a growing consensus towards the feasibility of cancer genetic testing being undertaken by non-genetic healthcare professionals in a collaborative oncogenetics service model.

Sexual Health in the Era of Cancer Genetic Testing: A Systematic Review

INTRODUCTION

Genetic testing for germline cancer mutations allows individuals to gain specific knowledge of their hereditary cancer risks. Although risk-reducing strategies such as increased screening, prophylactic surgeries, and chemoprevention may be potentially lifesaving, these options can also significantly impact sexual health and function.

AIM

This study overviews current challenges at the intersection of cancer genetic testing and sexual health and describes a systematic review that summarizes this evidence, identifies methodological limitations, and provides future research directions.

METHODS

Articles on the intersection of genetic testing and/or family history of cancer, cancer risk, and sexual health were searched in Medline, PsycINFO, and PsycARTICLES databases.

MAIN OUTCOME MEASURE

The main outcome measure was sexual health in women who pursued risk-reducing surgery.

RESULTS

On the basis of the inclusion criteria, 32 studies were reviewed. 31 contained empiric data from 3,367 participants; one was a conceptual study. All studies were published between 2000 and 2019. Mean ages ranged from 38 to 51.2.

CONCLUSION

Given the prevalence of sexual dysfunction after risk-reducing surgery, evidence-based interventions are needed. Furthermore, quality of life that includes sexual health, in at-risk women who pursue preventive surgery, remains an understudied aspect of cancer genetic testing. Yusufov M, Bober SL. Sexual Health in the Era of Cancer Genetic Testing: A Systematic Review. Sex Med Rev 2020;8:231-241.

Genetic and Genomic Advances in Breast Cancer Diagnosis and Treatment

Advances in genetic testing for people at high risk for cancer and in targeted gene therapy for breast cancer are rapidly emerging, including newly developed key hormone receptor-targeted therapies and individualized molecular fusion identification and treatment options. These advances are contributing to a new era in cancer treatment modalities and care delivery. As more innovative and advanced treatment options emerge, women's health outcomes and survival rates may improve. Nursing professionals in primary care and women's health specialties must be aware of the latest options for testing, referrals, and treatment modalities.