American Society of Clinical Oncology Policy Statement Update: Genetic and Genomic Testing for Cancer Susceptibility.
The American Society of Clinical Oncology (ASCO) has long affirmed that the recognition and management of individuals with an inherited susceptibility to cancer are core elements of oncology care. ASCO released its first statement on genetic testing in 1996 and updated that statement in 2003 and 2010 in response to developments in the field. In 2014, the Cancer Prevention and Ethics Committees of ASCO commissioned another update to reflect the impact of advances in this area on oncology practice. In particular, there was an interest in addressing the opportunities and challenges arising from the application of massively parallel sequencing-also known as next-generation sequencing-to cancer susceptibility testing. This technology introduces a new level of complexity into the practice of cancer risk assessment and management, requiring renewed effort on the part of ASCO to ensure that those providing care to patients with cancer receive the necessary education to use this new technology in the most effective, beneficial manner. The purpose of this statement is to explore the challenges of new and emerging technologies in cancer genetics and provide recommendations to ensure their optimal deployment in oncology practice. Specifically, the statement makes recommendations in the following areas: germline implications of somatic mutation profiling, multigene panel testing for cancer susceptibility, quality assurance in genetic testing, education of oncology professionals, and access to cancer genetic services.
Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson and Stephen M. Lipkin, Weill Cornell Medical College, New York, NY; Angela R. Bradbury and Susan M. Domchek, Hospital of the University of Pennsylvania, Philadelphia, PA; Banu Arun, MD Anderson Cancer Center, Houston, TX; James M. Ford, Stanford University Medical Center, Stanford, CA; Heather L. Hampel, Ohio State University Comprehensive Cancer Center, Columbus, OH; Sapna Syngal, Dana-Farber Cancer Institute, Boston, MA; Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ. robsonm@mskcc.org.
Mark E
ME
Robson
Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson and Stephen M. Lipkin, Weill Cornell Medical College, New York, NY; Angela R. Bradbury and Susan M. Domchek, Hospital of the University of Pennsylvania, Philadelphia, PA; Banu Arun, MD Anderson Cancer Center, Houston, TX; James M. Ford, Stanford University Medical Center, Stanford, CA; Heather L. Hampel, Ohio State University Comprehensive Cancer Center, Columbus, OH; Sapna Syngal, Dana-Farber Cancer Institute, Boston, MA; Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ.
Angela R
AR
Bradbury
Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson and Stephen M. Lipkin, Weill Cornell Medical College, New York, NY; Angela R. Bradbury and Susan M. Domchek, Hospital of the University of Pennsylvania, Philadelphia, PA; Banu Arun, MD Anderson Cancer Center, Houston, TX; James M. Ford, Stanford University Medical Center, Stanford, CA; Heather L. Hampel, Ohio State University Comprehensive Cancer Center, Columbus, OH; Sapna Syngal, Dana-Farber Cancer Institute, Boston, MA; Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ.
Banu
B
Arun
Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson and Stephen M. Lipkin, Weill Cornell Medical College, New York, NY; Angela R. Bradbury and Susan M. Domchek, Hospital of the University of Pennsylvania, Philadelphia, PA; Banu Arun, MD Anderson Cancer Center, Houston, TX; James M. Ford, Stanford University Medical Center, Stanford, CA; Heather L. Hampel, Ohio State University Comprehensive Cancer Center, Columbus, OH; Sapna Syngal, Dana-Farber Cancer Institute, Boston, MA; Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ.
Susan M
SM
Domchek
Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson and Stephen M. Lipkin, Weill Cornell Medical College, New York, NY; Angela R. Bradbury and Susan M. Domchek, Hospital of the University of Pennsylvania, Philadelphia, PA; Banu Arun, MD Anderson Cancer Center, Houston, TX; James M. Ford, Stanford University Medical Center, Stanford, CA; Heather L. Hampel, Ohio State University Comprehensive Cancer Center, Columbus, OH; Sapna Syngal, Dana-Farber Cancer Institute, Boston, MA; Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ.
James M
JM
Ford
Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson and Stephen M. Lipkin, Weill Cornell Medical College, New York, NY; Angela R. Bradbury and Susan M. Domchek, Hospital of the University of Pennsylvania, Philadelphia, PA; Banu Arun, MD Anderson Cancer Center, Houston, TX; James M. Ford, Stanford University Medical Center, Stanford, CA; Heather L. Hampel, Ohio State University Comprehensive Cancer Center, Columbus, OH; Sapna Syngal, Dana-Farber Cancer Institute, Boston, MA; Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ.
Heather L
HL
Hampel
Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson and Stephen M. Lipkin, Weill Cornell Medical College, New York, NY; Angela R. Bradbury and Susan M. Domchek, Hospital of the University of Pennsylvania, Philadelphia, PA; Banu Arun, MD Anderson Cancer Center, Houston, TX; James M. Ford, Stanford University Medical Center, Stanford, CA; Heather L. Hampel, Ohio State University Comprehensive Cancer Center, Columbus, OH; Sapna Syngal, Dana-Farber Cancer Institute, Boston, MA; Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ.
Stephen M
SM
Lipkin
Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson and Stephen M. Lipkin, Weill Cornell Medical College, New York, NY; Angela R. Bradbury and Susan M. Domchek, Hospital of the University of Pennsylvania, Philadelphia, PA; Banu Arun, MD Anderson Cancer Center, Houston, TX; James M. Ford, Stanford University Medical Center, Stanford, CA; Heather L. Hampel, Ohio State University Comprehensive Cancer Center, Columbus, OH; Sapna Syngal, Dana-Farber Cancer Institute, Boston, MA; Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ.
Sapna
S
Syngal
Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson and Stephen M. Lipkin, Weill Cornell Medical College, New York, NY; Angela R. Bradbury and Susan M. Domchek, Hospital of the University of Pennsylvania, Philadelphia, PA; Banu Arun, MD Anderson Cancer Center, Houston, TX; James M. Ford, Stanford University Medical Center, Stanford, CA; Heather L. Hampel, Ohio State University Comprehensive Cancer Center, Columbus, OH; Sapna Syngal, Dana-Farber Cancer Institute, Boston, MA; Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ.
Dana S
DS
Wollins
Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson and Stephen M. Lipkin, Weill Cornell Medical College, New York, NY; Angela R. Bradbury and Susan M. Domchek, Hospital of the University of Pennsylvania, Philadelphia, PA; Banu Arun, MD Anderson Cancer Center, Houston, TX; James M. Ford, Stanford University Medical Center, Stanford, CA; Heather L. Hampel, Ohio State University Comprehensive Cancer Center, Columbus, OH; Sapna Syngal, Dana-Farber Cancer Institute, Boston, MA; Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ.
Noralane M
NM
Lindor
D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000331:legislation & jurisprudence*; D015894:Genome, Human; D023281:Genomics; D018095:Germ-Line Mutation; D006297:Health Services Accessibility; D006801:Humans; D008495:Medical Oncology / Q000193:education / Q000331:legislation & jurisprudence* / Q000458:organization & administration*; D009369:Neoplasms / Q000235:genetics*; D058991:Patient Protection and Affordable Care Act; D011785:Quality Assurance, Health Care; D018570:Risk Assessment; D012955:Societies, Medical; D014481:United States