What role for public health in genetics and vice versa?
What role for public health in genetics and vice versa?
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DOI：
10.1159/000090688
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发表时间：
2006-01-01
期刊：
影响因子：
--
通讯作者：
Holtzman, NA
中科院分区：
文献类型：
--
作者：
Holtzman, NA
一些流行病学家和遗传学家声称，将遗传学纳入公共卫生政策和计划是必要且不可避免的。目标：探讨公共卫生和遗传学进一步整合的必要程度。方法：综合四个领域的文献：研究、遗传服务、监管和教育。该分析仅限于人类遗传学。结果：公众对基础遗传学研究的支持已经并将继续带来新的应用并进一步了解人类起源和传播。一些应用研究，特别是常见复杂疾病的遗传风险因素的研究，成果较低，最好得到私人资金的支持。唯一对公共卫生作用至关重要的遗传服务是新生儿筛查。随着基因专利的获得、基因测试商业利益的激增以及直接向公众进行广告，公共卫生机构的监管变得越来越重要。由于大多数基因检测和其他服务将由个人医疗保健系统提供，因此遗传学教育最好留给教育和医疗系统。公共卫生从业者应该意识到基因检测的局限性。结论：没有必要将遗传服务和教育进一步纳入公共卫生，特别是在公共和私人卫生服务二分的国家。然而，新生儿筛查和随访是在公共卫生的支持下最安全、最有效的方式提供。加强公共卫生作用的最重要领域是对主要由私营部门提供的基因检测和其他基因服务的监管。需要继续支持基础遗传学研究。版权所有 (C) 2006 S. Karger AG，巴塞尔。
Some epidemiologists and geneticists claim that integrating genetics into public health policies and programs is necessary and unavoidable. Objective: To examine the extent to which further integration of public health and genetics is warranted. Methods: Synthesis of the literature in four areas: research, genetic services, regulation, and education. The analysis is limited to human genetics. Results: Public support for basic genetic research has and will continue to lead to new applications and to further understanding of human origins and dispersions. Some applied research, particularly for genetic risk factors for common complex diseases, has low yield and is better supported by private funds. The only genetic service for which a public health role is paramount is newborn screening. With the patenting of genes, and the proliferation of commercial interests in genetic tests and directly advertising them to the public, regulation by public health agencies is increasingly important. As most genetic testing and other services will be provided in the personal health care system, education about genetics is best left to the educational and medical systems. Public health practitioners should be aware of the limitations of genetic tests. Conclusions: There is little need for further integration of genetic services and education into public health especially in countries in which public and private health services are dichotomized. Newborn screening and follow-up, however, are most safely and effectively provided under public health auspices. The most important area for strengthening the public health role is in the regulation of genetic tests and other genetic services provided primarily by the private sector. Continued support for basic genetic research is needed. Copyright (C) 2006 S. Karger AG, Basel.