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Addressing perceived economic obstacles to genetic testing as a way to mitigate disparities in family health history for adoptees

Published online by Cambridge University Press:  20 December 2018

Thomas May*
Affiliation:
Floyd and Judy Rogers Endowed Professor, Elson S. Floyd College of Medicine, Washington State University, Vancouver, WA, USA Ethics and Genomics Program, HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA Institute for Health and Aging, University of California San Francisco, San Francisco, CA, USA
James P. Evans
Affiliation:
Bryson Distinguished Professor of Genetics & Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
*
*Correspondence to: Thomas May, Washington State University Vancouver, 14204 Salmon Creek Ave, Vancouver, WA98686, USA. Email: [email protected]

Abstract

In this paper, we ask whether or not we can afford to realize the potential benefits of genetic testing as a screening tool for adoptees. Our method is to provide reasonable cost and savings estimates. We argue that the prospect of cost neutrality should be sufficient to explore the targeted screening for a population who will otherwise suffer an avoidable health disparity in access to inherited disease information. Our goal here is to establish that the investment needed to attain these benefits is not beyond our means.

Type
Articles
Copyright
© Cambridge University Press 2018

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References

Agalliu, IandWang, Z (2013) Characteriztion of SNPs associated with prostate cancer in men of Ashkenazic descent from the set of GWAS identified SNPs: impact of cancer family history and cumulative SNP risk prediction. PLoS One, 8, e60083.CrossRefGoogle Scholar
American Cancer Society (2016) What are the risk factors for ovarian cancer? http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-risk-factors [9 November 2018].Google Scholar
American Cancer Society (NDa) Genetic Testing, Screening, and Prevention for People with a Strong Family History of Colorectal Cancer. https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/genetic-tests-screening-prevention.html [9 November 2018].Google Scholar
American Cancer Society (NDb) Recommendations for Colorectal Cancer Early Detection. https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html [9 November 2018].Google Scholar
American Cancer Society (NDc) Guidelines for Breast Cancer Screening with MRI as an Adjunct to Mammography. http://onlinelibrary.wiley.com/doi/10.3322/canjclin.57.2.75/full [9 November 2018].Google Scholar
American Gastroenterological Association (ND) Diagnosis and Management of Lynch Syndrome. http://www.gastro.org/guidelines/diagnosis-and-management-of-lynch-syndrome [9 November 2018].Google Scholar
Anglian Breast Cancer Study Group (2000) Prevalence and penetrance of BRCA1 and BRCA2 mutations in a population-based series of breast cancer cases. British Journal of Cancer, 83(10): 13011308.CrossRefGoogle Scholar
Bellcross, C (ND) The Genetics of Early-Onset Breast Cancer. https://www.cdc.gov/cancer/breast/pdf/bellcross_gen_br_ca_yng_women.pdf [9 November 2018].Google Scholar
Blumen, H, Fitch, KandPolkus, V (2016) Comparison of treatment costs for breast cancer by tumor stage and type of service. American Health and Drug Benefits, 9(1): 2331.Google ScholarPubMed
Cancer.net (ND) Breast Cancer Statistics, http://www.cancer.net/cancer-types/breast-cancer/statistics [9 November 2018].Google Scholar
Chen, SandParmigiani, G (2007) Meta-analysis of BRCA-1 and BRCA-2 penetrance. J Clin Oncol, 25(11): 13291333.CrossRefGoogle Scholar
Classen, LandHenneman, L (2010) Using family history information to promote healthy lifestyles and prevent diseases: a discussion of the evidence. BMC Public Health, 10, 248.CrossRefGoogle Scholar
Grosse, S (2015) When is genomic testing cost-effective? Testing for Lynch syndrome in patients with newly-diagnosed colorectal cancer and their relatives. Healthcare (Basel), 3(4):860878. Epub.CrossRefGoogle ScholarPubMed
Grosse, S, Palomaki, G, Myundura, MandHampel, H (2015) The cost-effectiveness of routine testing for Lynch syndrome in newly diagnosed patients with colorectal cancer in the United States: corrected estimates. Genetics in Medicine, 17(6): 510511.CrossRefGoogle ScholarPubMed
Heald, B, Endelman, EandEng, C (2012) Prospective comparison of family medical history with personal genome screening for risk assessment of common cancers. European Journal of Human Genetics, 20, 547551.CrossRefGoogle ScholarPubMed
Health Costhelper (NDa) http://health.costhelper.com/mammogram.html [9 November 2018].Google Scholar
Health Costhelper (NDb) http://health.costhelper.com/hysterectomy.html [9 November 2018].Google Scholar
Hynes, D (2012) VA colon cancer quality and costs study: estimating healthcare costs for colon cancer. www.hsrd.research.va.gov/for_researchers/cyber_seminars/archives/hmcs-101712.pdf [9 November 2018].Google Scholar
Johnston, W (2017) Historical statistics on adoption in the U.S., plus statistics on child population and welfare. http://www.johnstonsarchive.net/policy/adoptionstats.html [9 November 2018]. (See also U.S. Census Statistics since 2002).Google Scholar
King, M, Levy-Lahad, EandLahad, A (2014) Population based screening for BRCA1 and BRCA2: 2014 Lasker award. JAMA, 312(11): 10911092.CrossRefGoogle ScholarPubMed
Klitzman, RandChung, W (2010) The process of deciding about prophylactic surgery for breast and ovarian cancer: patient questions, uncertainties, communication. American Journal of Medical Genetics, 152A(1): 5266.CrossRefGoogle ScholarPubMed
Kuchenbaecker, K, Hopper, JandBarnes, D, et al. (2017) Risk of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA, 317(23): 24022416.CrossRefGoogle ScholarPubMed
Lerman, C, Hughes, C, Croyle, RT, Main, D, Durham, C, Snyder, C, Bonney, A, Lynch, JF, Narod, SAandLynch, HT (2000) Prophylactic surgery decisions and surveillance practices one year following BRCA 1/2 testing. Preventive Medicine, 31, 7580.CrossRefGoogle Scholar
Louis, L, Christophe, SandCooper, A (2017) Long-term survival and cost of treatment in patients with Stage IIIC Epithelial Ovarian Cancer. Current Women’s Health Reviews, 13(2): 4450.Google Scholar
May, T, Lee, RandEvans, J (2018) Editors’ introduction: health challenges faced by adopted persons lacking family health history information. Narrative Inquiry in Bioethics, 18(2): 103106.CrossRefGoogle Scholar
May, TandStrong, K (2016a) Does lack of genetic relative family health history represent a potentially avoidable health disparity for adoptees? American Journal of Bioethics, 16(12): 3338.CrossRefGoogle Scholar
May, TandEvans, J (2016b) Issues of ‘cost, capabilities and scope’ in characterizing adoptees’ lack of genetic relative family health history as an avoidable health disparity. American Journal of Bioethics, 16(12): W4W8.CrossRefGoogle Scholar
May, T, Strong, K, Khoury, MandEvans, J (2015) Can targeted genetic testing offer usful health information to adoptees? Genetics in Medicine, 17(7): 533535.CrossRefGoogle Scholar
Meijers-Heijboer, EJ, Verhoog, LC, Brekelmans, CTM, Seynaeve, C, Tilanus-Linthorst, MMA, Wagner, A, Dukel, L, Devilee, P, van den Ouweland, AMW, van Geel, ANandKlijn, JGM (2000) Presymptomatic DNA testing and prophylactic surgery in families with a BRCA 1 or BRCA2 mutation. Lancet, 355, 20152020.CrossRefGoogle ScholarPubMed
Moyer, V, on behalf of the U.S. Preventive Services Task Force (USPSTF) (2014) Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women. Annals of Internal Medicine, 160(4): 271282.CrossRefGoogle ScholarPubMed
Myundra, M, Grosse, S, Hampel, HandPalomaki, G (2010) The cost-effectiveness of genetic testing strategies for Lynch syndrome among newly diagnosed patients with colorectal cancer. Genet Med, 12(2): 93104.Google Scholar
Rosenthal, E (2013) Colonoscopies explain why the U.S. leads the world in health expenditures, New York Times June 1, 2013. http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html?pagewanted=allGoogle Scholar
Siu, A, on behalf of the U.S. Preventive Services Task Force (2016) Screening for breast cancer: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine, 164(4): 279296.CrossRefGoogle ScholarPubMed
Smith, MandHochhalter, A (2011) Utilization of screening mammography among middle-aged and older women. Journal of Women’s Health, 20(11): 16191626.CrossRefGoogle ScholarPubMed
Quinn, GandVadaparampil, S (2016) Begging the question: the fallacy of adoptees as a health disparity. American Journal of Bioethics, 16(12): 4748.CrossRefGoogle ScholarPubMed
Warner, E, Plewes, DandHill, K (2004) Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mommography, and clinical breast examination. JAMA, 292(11): 13171325.CrossRefGoogle ScholarPubMed
Watson, B (2013) Breast cancer gene: why most women can’t do what Angelina Jolie did. aol.com Finance, https://www.aol.com/2013/05/15/angelina-jolie-breast-cancer-gene-cost/Google Scholar
Yarbroff, K, Borowski, LandLipsomb, J (2013) Economic studies in colorectal cancer: challenges in measuring and comparing costs. Journal of the National Cancer Institute Monograph, 2013(46): 6278.CrossRefGoogle Scholar