Organizing cancer genetics programs: the Swiss model.
OBJECTIVE
Inherited predisposition to cancer is a complex issue, and risk assessment, counseling, and management are multidisciplinary tasks. An infrastructure is needed through which clinical services may be delivered and research activities conducted.


METHODS
The Swiss Institute for Applied Cancer Research (SIAK) Network for Cancer Predisposition Testing and Counseling was established in 1999. The goals of the Network are to set common standards for clinical services, to coordinate research activities, to address psychosocial and ethical issues concerning genetic counseling and testing, and to translate the knowledge gained into medical practice.


RESULTS
An algorithm for genetic testing and counseling of the families studied by the SIAK Network centers has been established in a consensual process. Eight regional centers currently operate according to this algorithm. Furthermore, a proposal has been submitted for the setup of a Swiss databank for the characterization of BRCA1 and BRCA2 mutation patterns and the identification of potentially unique mutations in probands who seek genetic counseling and testing at the respective centers of the SIAK Network.


CONCLUSIONS
Our coordinated effort will ensure state-of-the-art genetic testing and counseling services in Switzerland and will allow us to acquire knowledge for appropriate risk assessment and surveillance/prevention strategies for individuals with an inherited cancer predisposition.
Pichert
G
G
Division of Oncology, Department of Medicine, University Hospital, Zürich, Switzerland.
Stahel
R A
RA
D000328:Adult; D000465:Algorithms; D001943:Breast Neoplasms / Q000235:genetics; D004992:Ethics, Medical; D005260:Female; D005817:Genetic Counseling / Q000458:organization & administration* / Q000523:psychology / Q000592:standards; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000458:organization & administration* / Q000523:psychology / Q000592:standards; D006801:Humans; D009369:Neoplasms / Q000235:genetics* / Q000517:prevention & control; D011584:Psychology; D018570:Risk Assessment; D013557:Switzerland