Lung Cancer
Tobacco products are the cause of 95 percent of all lung cancers. Smoking cessation and avoidance of all tobacco-related products are the best methods for decreasing your chances of getting lung cancer.
Currently, there is no widespread lung cancer screening test available to the general public. TheNational Cancer Institute is conducting a national lung screening trial to study the effectiveness of a chest X-ray versus a spiral CT scan.
Genetic Testing
Genetic testing is fast becoming a popular subject. Everywhere you look it seems there is something on the radio, television and even billboards offering genetic testing. But what does genetic testing really mean? Is genetic testing something that you need? Why should you do it? What do the results mean? These are just some of the questions that people are asking with sometimes very complex answers.
The American Society of Clinical Oncology (ASCO) released a policy statement on genetic and genomic testing for cancer susceptibility. Their statement includes eight recommendations that should be reviewed when considering genetic testing. A brief listing of each recommendation is outlined below:
Recommendation 1: Risk vs. Benefit.
Follow-up care should be planned based upon the level of risk associated with the gene being tested.
Recommendation 2: Education & Awareness.
Education provided should raise awareness of genetic testing for both the benefits as well as the limitations.
Recommendation 3: Investigational Study.
Genetic testing with uncertain clinical uses, such as a genomic risk assessment, should be done in the context of a clinical trial. In a clinical trial setting, evidence can be collected to prove the use of the test and how it benefits those taking the test.
Recommendation 4: Pre-test & Post-test Counseling.
Genetic testing should only be done with pre-testing and post-testing counseling by a professional. Pre-test counseling helps to provide education on why the test is being done and the information that will be obtained from the result. Post-test counseling is important so the results can be interpreted and communicated clearly and a follow up plan of care can be established.
Recommendation 5: Informed Consent.
Talk to your doctor about genetic testing if it is recommended. The discussion should include:
- The benefits of testing
- Who should be tested
- Positive vs. negative results
- Risk of passing a gene to a child
- Technical accuracy of the test
- Any fees involved with the test
- Psychological impacts of the test results
- Risks and protections of genetic discrimination by employers or insurers
- Confidentiality issues
- Further research on samples given
- Strategies for prevention after testing
- How to discuss results with at-risk relatives
- Plans for follow up after testing
Recommendation 6: Access to Testing.
ASCO supports the expansion of genetic and genomic testing and recommends that steps be taken to ensure access to testing for those who are in need of it.
Recommendation 7: Know Your Testing Company.
There are very few regulatory guidelines that involve genetic testing for independent laboratories. They should have written privacy policies that are easy to obtain by those being tested. Laboratories should be regulated by Clinical Laboratory Improvement Amendments (CLIA). Under CLIA, laboratories that provide testing services are required to meet standards for quality, accuracy, and reliability.
Recommendation 8: Increased Oversight.
ASCO promotes the use regulatory standards applied in a manner that is clear and efficient and does not unreasonably hinder scientific development or the delivery of quality oncology and preventive care. ASCO supports the development of a public registry that requires manufacturers of genetic tests, including independent direct to consumer (DTC) laboratories, to disclose information about their tests’ analytic validity, clinical validity, and clinical use.
It is important to remember that genetic testing may not be for all individuals or all types of cancers. Genetic testing and the pros and cons for each individual should be a discussion between the physician and patient in order to determine the best plan of action.
Genetic Information Nondiscrimination Act (GINA)
