Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Life
    • eLetters
    • Librarian information
    • Alerts
    • Resilience
    • Video
    • Audio
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
Advertisement
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Life
    • eLetters
    • Librarian information
    • Alerts
    • Resilience
    • Video
    • Audio
    • COVID-19 Clinical Solutions
Letters

Genetic cancer risk assessment in general practice: systematic review of tools available, clinician attitudes, and patient outcomes

Will RH Evans
British Journal of General Practice 2019; 69 (681): 177-178. DOI: https://doi.org/10.3399/bjgp19X702161
Will RH Evans
Division of Primary Care, NIHR School for Primary Care Research, University of Nottingham, Nottingham. Email:
Roles: GP and NIHR In-Practice Fellow
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: William.Evans1@nottingham.ac.uk
  • Article
  • Info
  • eLetters
  • PDF
Loading

The systematic review by Laforest et al is a timely addition to understand the challenges that expanding genetic risk assessment and into primary care pose.1 This is especially opportune given its online publication in the same week that the Secretary of State Matt Hancock announced the plan for the NHS to offer genomic testing to healthy individuals for a fee.2

Direct-to-consumer genetic testing is already available. Companies such as 23andme (https://www.23andme.com/en-gb/dna-health-ancestry/#all-reports-list) will give you a ‘genetic health risk’ including the cancer risk genes (BRCA1 and 2), Alzheimer’s dementia (APOE variant), as well as several other later-onset conditions and carrier status for in excess of 40 recessive conditions. Such testing currently has significant limitations, increasing health anxiety for some and falsely reassuring others.3 Such tests include substantial disclaimers, advice to discuss findings with healthcare professionals, and having confirmatory testing before taking action on any findings.

The NHS is also ‘mainstreaming’ genomic technologies for its patients, with the adoption of genetic testing outside of its traditional domain, clinical genetic departments. This change requires increased genomic literacy — discussing risks, interpreting results, and managing uncertainty — across a range of healthcare professionals including GPs.

The review by Laforest et al highlights the lack of knowledge and confidence that GPs have in one of these key areas, cancer genetics.1 They highlight the uncertainties and inconsistencies in how one should approach such patients and the lack of capacity in primary care to take on such a role. With the NHS now endorsing such direct-to-consumer testing, patients will undoubtedly wish and expect to be able to discuss findings with their GPs, who currently are inadequately prepared and resourced to do such a job.

How one should approach such a challenge is unclear. There is certainly a need for greater genomics education for the primary care team. It may also require a restructuring or expansion of the clinical genetics services, even a role for primary care-based genetic services.4 Greater clarity of appropriate referral pathways and respective responsibilities will also be critical to ensure that appropriate advice is given and resources are used optimally.

This review highlights some of the issues that will need to be overcome to fully embrace the potential of these genomic technologies in primary care.

  • © British Journal of General Practice 2019

REFERENCES

  1. 1.↵
    1. Laforest F,
    2. Kirkegaard P,
    3. Mann B,
    4. Edwards A
    (2019) Br J Gen Pract, Genetic cancer risk assessment in general practice: systematic review of tools available, clinician attitudes, and patient outcomes. DOI: https://doi.org/10.3399/bjgp18X700265.
  2. 2.↵
    (Jan 26, 2019) BBC News, NHS to offer paid-for DNA tests if patients share data. https://www.bbc.co.uk/news/uk-47013914 (accessed 5 Mar 2019).
  3. 3.↵
    1. Rafi I,
    2. Qureshi N,
    3. Lucassen A,
    4. et al.
    (2009) Br J Gen Pract, ‘Over-the-counter’ genetic testing: what does it really mean for primary care? DOI: https://doi.org/10.3399/bjgp09X395021.
  4. 4.↵
    1. Westwood G,
    2. Pickering R,
    3. Latter S,
    4. et al.
    (2012) Br J Gen Pract, A primary care specialist genetics service: a cluster-randomised factorial trial. DOI: https://doi.org/10.3399/bjgp12X630089.
View Abstract
Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 69 (681)
British Journal of General Practice
Vol. 69, Issue 681
April 2019
  • Table of Contents
  • Index by author
Download PDF
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Genetic cancer risk assessment in general practice: systematic review of tools available, clinician attitudes, and patient outcomes
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Genetic cancer risk assessment in general practice: systematic review of tools available, clinician attitudes, and patient outcomes
Will RH Evans
British Journal of General Practice 2019; 69 (681): 177-178. DOI: 10.3399/bjgp19X702161

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Genetic cancer risk assessment in general practice: systematic review of tools available, clinician attitudes, and patient outcomes
Will RH Evans
British Journal of General Practice 2019; 69 (681): 177-178. DOI: 10.3399/bjgp19X702161
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • REFERENCES
  • Info
  • eLetters
  • PDF

More in this TOC Section

  • It’s time to look again at GP funding
  • Inequalities in CKD management can be overcome
  • Changes in patient experience associated with growth and collaboration in general practice
Show more Letters

Related Articles

Cited By...

Advertisement

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers
  • RCGP e-Portfolio

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7679
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2021 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242