Genetic predisposition to cancer: more and more diagnoses

Genetic predisposition to cancer: more and more diagnoses

In France, the national oncogenetics system allows people with cancer and their families to decide on the existence of a genetic background favorable to the disease. In 2014, 56,897 consultations were carried out across the country, ie 18% more than in 2013. This growth is not without its problems, with waiting times also getting longer all the time.

More of 80 genes of genetic predisposition to cancers are now identified. Having either of these genes does not imply that cancer will automatically grow. However, on the scale of a population, we find that their carriers have a significantly increased risk – sometimes slightly, sometimes very strongly – of developing this disease.

In France, a person with cancer can apply for national oncogenetics system [1] in order to retroactively establish whether he is a carrier of such a gene. If the fact is proven, other members of his family will be able, if they wish, to carry out the screening. If a favorable genetic background is suspected, a healthy person can also use the device.

According to a balance sheet from the National Cancer Institute, published on January 6, 2016, the number of consultations has been growing steadily since 2003. In 2014, 56,897 consultations were carried out across the country, ie 18% more than in 2013 (48,434 consultations).

More than 52% of consultations result in a laboratory test (29,850 in 2014), a figure also on the rise (+21% of patients tested and +25% of healthy people compared to 2013). Two-thirds of these tests are on sick people. In 2014, 2,863 patients and 3,661 “relatives” were identified as carriers of a genetic mutation predisposing them to cancer.

“The majority of oncogenetics consultations carried out are dedicated to the breast-ovary syndrome and digestive pathologies”, details INCa in its annual report. “However, if significant and regular progressions have been observed since 2003 concerning the breast-ovary syndrome, the identification of people affected by a Lynch syndrome (colorectal cancer of genetic origin, Editor’s note) is not yet optimal”, regrets the Institute, which wishes to improve in the future the orientation of patients towards the national oncogenetics system.

But a problem is emerging: with the increase in the number of consultations, “the median time to obtain a first consultation appointment for a [patient malade] increased”going from 12 to 13 weeks between 2013 and 2014. This is one month more than in 2012. breasts-ovaries or Lynch syndrome).

Healthy people identified as predisposed to cancer can benefit from increased medical supervision and, depending on the case, be offered preventive surgery. According to INCa, “as of December 31, 2014, in a context of breast-ovary syndromeof Lynch syndrome or of familial adenomatous polyposis10,701 people in total received a personalized follow-up program and 77% of them (8,238) benefited from at least one support coordinated by the programs.”

[1] As the INCa points out, the national oncogenetics system is organized around 130 consultation sites distributed in 90 cities in metropolitan France and in the overseas departments; 25 laboratories carry out the genetic tests prescribed by the consultations.

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