Statement of the American Society of Clinical Oncology : Genetic testing for cancer susceptibility. Commentaries
Statement of the American Society of Clinical Oncology : Genetic testing for cancer susceptibility. Commentaries
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美国临床肿瘤学会声明：癌症易感性基因检测。
DOI：
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发表时间：
1996
期刊：
影响因子：
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通讯作者：
M. Skolnick
中科院分区：
文献类型：
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作者：
F. Visco;M. Skolnick
作为治疗癌症患者的领先医生组织，美国临床肿瘤学会 (ASCO) 认识到癌症专家必须充分了解癌症风险基因检测所涉及的一系列问题。新发现且仍在发展中的识别癌症风险最高个体的能力有望改善癌症的预防和早期发现。它还带来潜在的医疗、心理和其他个人风险，必须在基因检测知情同意的情况下解决这些风险。 ASCO 坚信，任何提供基因检测的医生都应该了解并能够传达当前检测程序的好处和局限性，以及患者及其家人可用的预防和治疗方案的范围。出于这些原因，ASCO 认可以下原则：.ASCO 肯定了临床肿瘤学家在记录患者癌症家族史、提供有关家族癌症风险以及预防和早期检测选择的咨询、以及认可基因检测可作为咨询辅助手段的家庭方面的作用。 。应尽可能在长期结果研究的背景下进行癌症易感性基因检测。 ASCO 支持制定和实施具有适当保密性的国家合作研究/注册，以定义已知癌症易感基因突变的临床意义。 。 ASCO 致力于为医生提供有关定量癌症风险评估方法、基因检测以及检测前和检测后遗传咨询的教育机会，以便肿瘤科医生能够更负责任地将遗传咨询和检测融入临床和预防肿瘤学实践中。 。肿瘤学家必须确保患者已给予知情同意，作为遗传倾向测试过程的一个组成部分，无论此类测试是在临床还是研究基础上提供。 。 ASCO 建议仅在以下情况下提供癌症易感性检测： 1) 该人有明显的癌症家族史或发病年龄很小； 2) 测试能够得到充分的解释； 3）结果将影响患者或家属的医疗管理。随着临床检测变得越来越广泛，协会鼓励肿瘤学家利用致力于验证检测方法的实验室，并促进家庭参与长期结果研究。 。 ASCO 建议肿瘤学家在测试前和测试后咨询中纳入对癌症早期检测和预防方式的可能风险和益处的讨论，这些方式对于癌症遗传风险最高的个体具有假定但未经证实的功效。 。 ASCO 支持加强对提供癌症易感性测试的实验室的监管权力，这些测试将用于为临床决策提供信息。这些监管要求应包括对基因检测中使用的产品、参考样本的实验室间比较以及质量控制机制进行适当的监督。 。 ASCO 支持所有努力，包括立法禁止保险公司或雇主基于个人遗传性癌症易感性进行歧视。
As the leading organization of physicians who treat people with cancer, the American Society of Clinical Oncology (ASCO) recognizes that cancer specialists must be fully informed of the range of issues involved in genetic testing for cancer risk. The newly discovered and still developing ability to identify individuals at highest risk for cancer holds the promise of improved prevention and early detection of cancers. It also poses potential medical, psychological, and other personal risks that must be addressed in the context of informed consent for genetic testing. ASCO firmly believes that any physician who offers genetic testing should be aware of, and able to communicate, the benefits and limits of current testing procedures, and the range of prevention and treatment options available to patients and their families. For these reasons, ASCO endorses the following principles : .ASCO affirms the role of clinical oncologists in documenting a family history of cancer in their patients, providing counseling regarding familial cancer risk and options for prevention and early detection, and recognizing those families for which genetic testing may serve as an aid in counseling. . To the greatest extent possible, genetic testing for cancer susceptibility should be performed in the setting of long-term outcome studies. ASCO endorses the formulation and implementation of a national cooperative study/registry with appropriate confidentiality to define the clinical significance of mutations in known cancer susceptibility genes. . ASCO is committed to providing educational opportunities for physicians concerning methods of quantitative cancer risk assessment, genetic testing, and pre- and post-test genetic counseling so that oncologists may more responsibly integrate genetic counseling and testing into the practice of clinical and preventive oncology. . Oncologists must assure that informed consent has been given by the patient as an integral part of the process of genetic predisposition testing, whether such testing is offered on a clinical or research basis. . ASCO recommends that cancer predisposition testing be offered only when : 1) the person has a strong family history of cancer or very early age of onset of disease ; 2) the test can be adequately interpreted ; and 3) the results will influence the medical management of the patient or family member. As clinical testing becomes more widely available, the Society encourages oncologists to utilize laboratories committed to the validation of testing methodologies, and to facilitate families' participation in long-term outcome studies. . ASCO recommends that oncologists include in pre- and post-test counseling discussion of possible risks and benefits of cancer early detection and prevention modalities, which have presumed but unproven efficacy for individuals at the highest hereditary risk for cancer. . ASCO endorses efforts to strengthen regulatory authority over laboratories that provide cancer predisposition tests that will be utilized to inform clinical decisions. These regulatory requirements should include appropriate oversight of the products used in genetic testing, interlaboratory comparisons of reference samples, as well as quality control mechanisms. . ASCO endorses all efforts including legislation to prohibit discrimination by insurance companies or employers based on an individual's inherited susceptibility to cancer.