Review Article

Predictive Genetic Testing: Can Specialized Advanced Practitioners Quell Consumer Confusion?

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ABSTRACT

It is currently common to see advertisements on television, in magazines, and on the Internet for genetic tests to evaluate one's own risk for cancer. Medical direct-to-consumer (DTC) marketing is not new to us—we are used to seeing advertisements for medications, medical tests, and treatments to "ask your doctor about." But how well do these DTC campaigns, specifically those for genetic tests for cancer susceptibility, inform the general public about hereditary cancer and the risk of carrying a mutation? More importantly, how much do general health-care providers and even oncology practitioners understand about genetic testing for hereditary cancer syndromes? This article will discuss hereditary cancer syndromes, the genetics of inherited mutations, and the process of evaluating who is an appropriate candidate to undergo predictive genetic testing (PGT) for hereditary cancer syndrome–associated mutations. Psychosocial and family implications as well as the ethical, legal, regulatory, and social issues associated with PGT will be briefly touched upon. Both the positive and negative implications of DTC marketing of genetic testing as well as a discussion of research and lessons learned related to DTC marketing for PGT will be presented. As information and understanding of genetics continues to grow and evolve, a health-care provider dedicated to cancer genetics is crucial. Advanced practitioners who further specialize and credential in genetics are the ideal health-care professionals to fill this important role.

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