Jeffrey N. Weitzel, M.D., chief of the Division of Clinical Cancer Genetics, along with two other leading oncogeneticists and American Society of Clinical Oncology (ASCO) staff, updated ASCO’s policy statement on genetic and genomic testing for cancer susceptibility. His contributions further City of Hope’s leadership in developing policies for genetic testing of cancer risk.
|Jeffrey Weitzel, right, tells Gloria Nuñez about the American Society of Clinical Oncology’s updated genetic and genomic testing policy. (Photo by Darrin S. Joy)|
Published in the Feb. 10 issue of the Journal of Clinical Oncology, the policy statement outlines ASCO’s position on the role of genetic testing in cancer clinical practice and research as well as education of oncologists and other cancer care providers, counseling of patients before and after testing, informed consent, laboratory regulation, access, reimbursement and protection from genetic discrimination.
The current genetic testing policy statement is the third revision from ASCO; its first statement on genetic testing came in 1996. The move reflects the recent growth in such testing: A federal scientific panel recently reported that 1,100 such tests are now available. These tests may highlight a patient’s risk for prostate, breast and other cancers, as well as heart disease and other conditions.
It also comes at a time when companies are increasingly marketing testing straight to consumers. As a result, the authors addressed new developments in the field, including “genetic tests of uncertain clinical utility” and direct-to-consumer testing.
Genetic tests of uncertain clinical utility include tests for minor variations that are fairly common. The variant mutations only slightly increase disease risk and rarely require that a patient or health-care provider take action.
“Awareness of these mutations might be important for later reference,” said Weitzel, “but in most cases they won’t affect disease management.”
Weitzel and his coauthors recommend addressing the usefulness of these tests with clinical studies to find when they are appropriate and how best to use the results in clinical practice.
The authors also addressed direct-to-consumer testing. Several commercial testing labs offer genetic tests directly to the public, often through the Internet. This testing bypasses health-care providers specifically trained to order tests when appropriate, explain the results to patients and coordinate follow-up care.
The safety and usefulness of direct-to-consumer tests are uncertain, warned the authors, who recommended stronger regulation of testing agencies.
The authors also noted that federal regulation of genetic testing remains insufficient and recommended increased oversight “to ensure that test results form a reliable foundation for medical decision making.”
Weitzel’s contribution to the ASCO policy statement marks the latest instance of his program’s impact on national health-care guidelines. His previous research led to changes in National Comprehensive Cancer Network guidelines in ovarian cancer screening and breast cancer screening.
Founded in 1964, ASCO is a nonprofit organization that aims to improve cancer care and prevention. The organization comprises more than 27,000 oncology practitioners from all oncology disciplines and subspecialties.