title: Do Health Professionals Need Additional Competencies for Stratified Cancer Prevention Based on Genetic Risk Profiling?
abstract: There is growing evidence that inclusion of genetic information about known common susceptibility variants may enable population risk-stratification and personalized prevention for common diseases including cancer. This would require the inclusion of genetic testing as an integral part of individual risk assessment of an asymptomatic individual. Front line health professionals would be expected to interact with and assist asymptomatic individuals through the risk stratification process. In that case, additional knowledge and skills may be needed. Current guidelines and frameworks for genetic competencies of non-specialist health professionals place an emphasis on rare inherited genetic diseases. For common diseases, health professionals do use risk assessment tools but such tools currently do not assess genetic susceptibility of individuals. In this article, we compare the skills and knowledge needed by non-genetic health professionals, if risk-stratified prevention is implemented, with existing competence recommendations from the UK, USA and Europe, in order to assess the gaps in current competences. We found that health professionals would benefit from understanding the contribution of common genetic variations in disease risk, the rationale for a risk-stratified prevention pathway, and the implications of using genomic information in risk-assessment and risk management of asymptomatic individuals for common disease prevention.
authors.affiliation: PHG Foundation, 2 Worts Causeway, Cambridge CB1 8RN, UK. susmita.chowdhury@phgfoundation.org.
authors.forename: Susmita
authors.initials: S
authors.lastname: Chowdhury
authors.affiliation: Department of Clinical Genetics, Section Community Genetics, and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, PO Box 7057, 1007 MB, The Netherlands. L.Henneman@vumc.nl.
authors.forename: Lidewij
authors.initials: L
authors.lastname: Henneman
authors.affiliation: PHG Foundation, 2 Worts Causeway, Cambridge CB1 8RN, UK. tom.dent@phgfoundation.org.
authors.forename: Tom
authors.initials: T
authors.lastname: Dent
authors.affiliation: PHG Foundation, 2 Worts Causeway, Cambridge CB1 8RN, UK. alison.hall@phgfoundation.org.
authors.forename: Alison
authors.initials: A
authors.lastname: Hall
authors.affiliation: UCL Division of Infection and Immunity, University College London, Cruciform Building, 90 Gower Street, London WC1E 6BT, UK. alice.burton.14@ucl.ac.uk.
authors.forename: Alice
authors.initials: A
authors.lastname: Burton
authors.affiliation: Departments of Oncology and of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK. pp10001@medschl.cam.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Pharoah
authors.affiliation: UCL Department of Applied Health Research, University College London, 1-19 Torrington Place, London WC1E 6BT, UK. n.pashayan@ucl.ac.uk.
authors.forename: Nora
authors.initials: N
authors.lastname: Pashayan
authors.affiliation: PHG Foundation, 2 Worts Causeway, Cambridge CB1 8RN, UK. hilary.burton@phgfoundation.org.
authors.forename: Hilary
authors.initials: H
authors.lastname: Burton
keywords: common-disease prevention; competence; genetic risk; health professionals; knowledge; risk-assessment; risk-stratified prevention; risk-stratified screening; risk-tools; skills