RLO: Clinical Utility of Genetic Information

• Introduction
• Effective Interventions
• Social Consequences
• Patient Experience
• Economic Implications
• Summary

The social consequences of genetic information

Interventions: Colorectal cancer screening procedure involves fiberoptic examination of the colon, with removal of polyps or early cancer. Colectomy performed mainly for patients with FAP, is a more serious operation. Depending on the type of surgery, patients may be in hospital for up-to a week and recuperate at home for four to six weeks. This can be especially difficult when this surgery is preformed on children.

Empowering the patient: Patients may feel that information about their genetic risk provides them with a sense of control by providing information about appropriate screening or lifestyle changes that could reduce their risk.

Negative emotions: Discovering you are at increased risk for a genetic condition may increase feelings of anxiety, uncertainty and depression about the possibility of developing cancer. Some people may start to think of themselves as "sick," even if they never develop the condition. Genetic counselling can help in dealing with these feelings, especially if a patient is considering genetic testing for a condition associated with high cancer risk.

Family dynamics: Patients may feel a responsibility to share genetic information with family members, and at the same time may feel uncomfortable about doing so. Survivor guilt may be an issue, if a member of a high risk family is found not to have inherited the cancer predisposition.

When a specific cancer-predisposing mutation is identified, knowledge of which family members carry the mutation, and which do not, provides useful information by eliminating the need for increased surveillance in those unaffected members.