Rapidly evolving genetic and genomic technologies for genetic cancer risk assessment (GCRA) are revolutionizing the approach to targeted therapy and cancer screening and prevention, heralding the era of personalized medicine. Although academic health centers have traditionally led the diffusion of new technologies into community practice, commercial availability and marketing of genetic testing have accelerated the uptake of testing in the community setting, where clinicians are often inadequately prepared to select, apply, and interpret genetic tests. Consequently, many questions remain about the composition of the personalized medicine workforce and challenges related to developing and sustaining best practices in GCRA in the community setting. This article describes some alternate approaches to delivery of high-quality GCRA services that leverage the expertise of the academic health center to promote access and quality care through advanced training and ongoing practice-centered support for community-based clinicians.
The research and education programs described in this manuscript were supported by several sources of funding: Cancer Genetics Education Program supported in part by National Cancer Institute Grants 2R25 CA75131, R25 CA112486, and R25 CA85771, and by Project # MCHG-51 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services. Underserved outreach programs were supported in part by California Cancer Research Program Grant Number 00-92133, and by project # POP0600464 from Susan G. Komen for the Cure. The Registry and The City of Hope Center for Cancer Genetics Technology Transfer Research was supported in part by the California Cancer Research Program, Grant No. 99-86874, and by a general clinical research center grant from NIH (M01 RR00043) awarded to the City of Hope National Medical Center, Duarte, California.
The authors wish to thank all the community colleagues and administrators who played important roles in the development of the network sites, including Frederick Kass, MD; Clarence Petrie, MD; Ian Grady, MD; Anita Gregory, MD; David King, MD (in memoriam); Kimberly Banks, MS, CGC; David Margileth, MD; Joan Taylor, MBA; Patty Dock, MS, CGC; Jane Congleton, RN, MS, CGC; Nancy Feldman, MD; Lori Viveros, MPH, CHES; Taema Weiss, MD; and Ellen B. Castleman, BS, RTT.
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