Integrating hereditary breast and ovarian cancer genetic counselling and testing into mainstream clinical practice: Legal and ethical challenges

Crit Rev Oncol Hematol. 2022 Oct:178:103797. doi: 10.1016/j.critrevonc.2022.103797. Epub 2022 Aug 27.

Abstract

Health professionals not specialized in genetics are expected to take an increasing role in genetic services delivery. This article aims to identify legal and ethical challenges related to a collaborative oncogenetics service model, where non-genetic health professionals provide genetic services to patients. Through a scoping literature review, we identified issues to the provision of hereditary breast and ovarian cancer, or other hereditary adult cancers, genetic testing under this model. Concerns that arose in the literature were informed consent, lack of adherence to best practice guidelines, lack of education of non-genetic health professionals on the provision of genetic services, psychological impacts of genetic testing, continuity of care, the complexity of genetic test results, confidentiality, risks of medical mismanagement, and the associated medical responsibility liabilities. Despite these challenges, there is a growing consensus towards the feasibility of cancer genetic testing being undertaken by non-genetic healthcare professionals in a collaborative oncogenetics service model.

Keywords: Ethical issues; Genetic testing; Legal issues; Oncogenetics; Oncology; Primary care; Service models in oncogenetics.

Publication types

  • Review

MeSH terms

  • Adult
  • Carcinoma, Ovarian Epithelial
  • Confidentiality
  • Female
  • Genetic Counseling*
  • Genetic Testing
  • Humans
  • Ovarian Neoplasms* / diagnosis
  • Ovarian Neoplasms* / genetics