Genetic Testing

The American Society of Clinical Oncology (ASCO) released its first statement on genetic testing in 1996, and updated the statement in 2003 and 2010 in response to developments in the field. In 2014, the Cancer Prevention and Ethics Committees of ASCO commissioned another update to reflect the impact of advances in this area on oncology practice, such as massively parallel sequencing, which is also known as next generation sequencing.

This emerging technology introduces a new level of complexity in the practice of cancer risk assessment. The statement makes detailed recommendations in the following areas: germline implications of somatic mutation profiling, multigene panel testing for cancer susceptibility, quality assurance in genetic testing, education of oncology professionals, and access to cancer genetic services. The updated statement was published in the Journal of Clinical Oncology on 8/31/15 and can be accessed online at http://jco.ascopubs.org/content/early/2015/08/31/JCO.2015.63.0996.full.

Among the detailed recommendations is ASCO’s statement that the recognition and management of individuals at inherited risk for cancer is a core element of oncology practice. The skills required to provide cancer risk assessment services are not specific to a particular discipline but rather incorporate elements from oncology, medical genetics and genetic counseling, and other disciplines.

ASCO recommends continued education of oncologists and other healthcare professionals in the area of cancer risk assessment and management of individuals with an inherited predisposition to cancer, and recommends specific skills be integrated into oncology training and continuing education. This is perhaps the most important recommendation, since appropriate use of genetic testing is unlikely to occur if the patient’s healthcare providers are uninformed or not fully informed about their indication and relevance to practice.