Answering needs and deficits: The 2013 APHA Cancer genomics in public health policy statement

Two powerful forces are coming together in cancer genetic testing to produce a population-wide impact: the development of an evidence base for tiered levels of oncogenomic testing (predictive testing for BRCA mutations and Lynch syndrome achieving highest validity), and enhanced availability of testing through judicial patenting changes and the Affordable Care Act. Groups experiencing disparities – Latinos and African Americans (half as likely as whites to receive cancer genetic testing and counseling) and those living in rural areas – can benefit now if suitable policies are achieved. In this session we will detail the 2013 APHA “Advancing Cancer Genomics in Public Health” policy statement spearheaded by the APHA Genomics Forum, and connect it with recent events in public health. Topics to be covered include: new developments in cancer family history and the rise of cascade screening; the varieties of cancer genetic testing that have emerged, from predictive testing to cancer pharmacogenomics; the antipodes of state-level cancer genetic surveillance programs and personalized, direct-to-consumer cancer genetic testing; and educational programs informed by public health provider and consumer needs. Genetic databases and genome-wide association studies must include data representing a diversity of cultural backgrounds and levels of exposure impacting genes. Recommendations falling into 4 categories (information-related (including electronic systems), intervention (testing, counseling, education)-related, disparities-oriented, and regulatory) will be covered. Together we will look at the action question of whether current policies (genetic testing guidelines, state educational-surveillance programs, Medicare and Medicaid coverage) are enough.