HOW DO I KNOW IF I’M A CANDIDATE FOR GENETIC EDUCATION OR TESTING?
Genetic testing isn’t right for everyone, and genetic education and testing is an important part of the genetic evaluation. You are encouraged to talk to your doctor about your family history to determine if you need a genetic evaluation or complete this family history screening form.
Approximately 10% of cancers are hereditary meaning that a mutation in a gene leads to an increased risk for certain cancers. When families have a hereditary predisposition to cancer, we typically see:
- Early onset cancers (ex. Breast cancer before age 50)
- Rare cancers (ex. Ovarian cancer or pancreatic cancer)
- Multiple primary cancers in one person
- Multiple generations affected
WHAT DO I DO WITH THE RESULTS OF GENETIC TESTING?
Identifying specific gene mutations can help to clarify the type of cancers you may be more susceptible to and the level of risk to develop these cancers. The ultimate goal of genetic education and testing is to create an individualized medical management plan intended to prevent cancer or detect cancer as early as possible, if a cancer develops.
Management recommendations may be advised based on genetic test results as well as family history of cancer. Recommendations could include:
- Close surveillance (screening/exams)
- Risk-reducing surgery
- Risk-reducing medications
Additionally, family members may be advised to consider genetic testing or pursue increased surveillance as well.
WILL INSURANCE PAY FOR GENETIC TESTING?
Your genetic educator, Gloria Drouin can help determine if you are a good candidate for testing and if you meet your insurance criteria for testing. Typically, if you decide to pursue testing, your sample, personal and family history information, and insurance card(s) are sent to the testing laboratory in order for them to complete an insurance benefits investigation. The laboratory will then contact you to let you know your expected out of pocket cost and give you the opportunity to cancel testing for financial reasons. Self-pay options are also available.
WILL GENETIC TESTING AFFECT MY INSURABILITY?
The Genetic Information Nondiscrimination Act (GINA) of 2008 prohibits discrimination in health insurance coverage and employment based upon genetic information (with exception in companies with 15 or fewer employees). Missouri State laws protect the privacy of genetic information and prohibit individuals from being denied health insurance, group disability insurance or long-term care insurance based on genetic information. No federal or state laws in Missouri have protections regarding life insurance. For more information, click here.
NOW WHAT? DECIDING WHAT TO DO (OR NOT DO) AFTER GENETIC TESTING
Once your genetic test has been analyzed, you and your physician will sit down together to discuss your result and determine the next steps to take.
If your results are negative (no genetic change is found), your doctor will review your personal and family history with you, discuss your cancer risks and determine the best personalized screening schedule. Even if your genetic testing is negative, you may still be at high risk and need additional screening.
If your results are positive (a genetic change linked to cancer risk is found), you may have several choices including:
- Heightened surveillance uses more frequent screenings, starting at a younger age than usual or having a different kind of screening for the cancer type for which you have a high risk.
- Chemoprevention uses medication to help reduce risk of cancer. It cannot prevent cancer with 100 percent certainty, but it can lower risks for certain types of cancer.
- Prophylactic (risk reducing) surgery removes the organs that have a higher cancer risk. The decision to have prophylactic surgery is a significant choice that you should make in consultation with a physician. Your doctor will also discuss what your test results mean for your relatives, as they may also be at increased risk and need testing.