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      Genetic Counseling and Testing in a Community Setting: Quality, Access, and Efficiency

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          Abstract

          There is an increasing need for genetic counseling and testing for individuals diagnosed with cancer, as treatment may be affected by the results. In addition, the identification of individuals before a diagnosis of cancer allows for optimal surveillance and early detection and prevention of cancer. With the recognition that as much as 10% of all cancers are hereditary, there is a growing need to improve access to genetic counseling and genetic testing, both before and at the time of diagnosis. This article focuses on models of identifying at-risk patients, including underserved communities; providing genetic counseling and testing in community practices; using telehealth; and collaborating with nongenetics health care providers and technological solutions to maximize efficiency and access.

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          Most cited references108

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          Closing the gap in a generation: health equity through action on the social determinants of health.

          The Commission on Social Determinants of Health, created to marshal the evidence on what can be done to promote health equity and to foster a global movement to achieve it, is a global collaboration of policy makers, researchers, and civil society, led by commissioners with a unique blend of political, academic, and advocacy experience. The focus of attention is on countries at all levels of income and development. The commission launched its final report on August 28, 2008. This paper summarises the key findings and recommendations; the full list is in the final report.
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            Inherited DNA-Repair Gene Mutations in Men with Metastatic Prostate Cancer.

            Inherited mutations in DNA-repair genes such as BRCA2 are associated with increased risks of lethal prostate cancer. Although the prevalence of germline mutations in DNA-repair genes among men with localized prostate cancer who are unselected for family predisposition is insufficient to warrant routine testing, the frequency of such mutations in patients with metastatic prostate cancer has not been established.
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              Inherited Mutations in Women With Ovarian Carcinoma.

              Germline mutations in BRCA1 and BRCA2 are relatively common in women with ovarian, fallopian tube, and peritoneal carcinoma (OC) causing a greatly increased lifetime risk of these cancers, but the frequency and relevance of inherited mutations in other genes is less well characterized.
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                Author and article information

                Journal
                American Society of Clinical Oncology Educational Book
                American Society of Clinical Oncology Educational Book
                American Society of Clinical Oncology (ASCO)
                1548-8748
                1548-8756
                May 2019
                May 2019
                : 39
                : e34-e44
                Affiliations
                [1 ]Cancer Genetics Risk Assessment Program, Ascension St. Vincent, Indianapolis, IN
                [2 ]Department of Medicine, Division of Hematology-Oncology, Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA
                [3 ]The University of Illinois at Chicago, Chicago, IL
                [4 ]The University of Texas MD Anderson Cancer Center, Houston, TX
                Article
                10.1200/EDBK_238937
                31099680
                7be7e0b6-bd47-4049-a338-c83c807d7d95
                © 2019
                History

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