title: Cancer genetic counseling in public health care hospitals: the experience of three Brazilian services.
abstract: In Brazil, genetic counseling is usually available in university-affiliated medical genetics services located in tertiary centers that provide cancer diagnosis and treatment. The present study aims to describe the structure and characteristics of three cancer genetic services in Brazilian public health care hospitals and discuss alternatives for the identification and prevention of hereditary cancer syndromes in developing countries. The three services presented here are similar in their structure, routine procedures for cancer risk estimation and criteria for the indication of genetic testing. They all demand that genetic counseling be an essential part of the cancer risk evaluation process, before and after cancer predisposition testing. However, when high-risk patients are identified, all services describe difficulties in the access and continuity of genetic and medical services to the patient and his/her at-risk relatives. The services differ in the type of population served, reflecting distinct referral guidelines. This study emphasizes the importance of the creation of new cancer genetic services in other Brazilian regions and the necessity for establishing a collaborative network to facilitate the diagnosis and research of cancer genetic syndromes.
authors: Department of Genetics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors: Edenir Inez
authors: EI
authors: Palmero
authors: Luciane
authors: L
authors: Kalakun
authors: Lavinia
authors: L
authors: Schüler-Faccini
authors: Roberto
authors: R
authors: Giugliani
authors: Fernando
authors: F
authors: Regla Vargas
authors: José Cláudio C
authors: JC
authors: Rocha
authors: Patricia
authors: P
authors: Ashton-Prolla
mesh_terms: D001938:Brazil; D005817:Genetic Counseling / Q000458:organization & administration*; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000458:organization & administration*; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis / Q000235:genetics*; D019982:Organizational Case Studies