Abstract
IntroductionComprehensive Cancer Control (CCC) plans address cancer burden at the state level through consolidation of activities and collaboration among stakeholders. Public health genomics strategies are increasingly important in prevention and treatment of cancer. The objectives of this study were to assess the extent to which CCC plans have incorporated genomics-related terms since 2005, determine which of the 3 core public health functions were fulfilled by genomics components, and identify facilitators of and barriers to integration of genomics.MethodsWe reviewed 50 CCC plans in 2010 to assess use of 22 genomics-related terms. Among plans that used the term genetics or genomics, we examined the plan for inclusion of genomics-related goals, objectives, or strategies and documented the 3 core public health functions (assessment, policy development, and assurance) fulfilled by them. We surveyed plan coordinators about factors affecting incorporation of genomic strategies into plans.ResultsForty-seven of 50 (94%) plans included at least 1 genomics-related term. Thirty-two of 50 (64%) plans included at least 1 genomics-related goal, objective, or strategy, most encompassing the core function of assurance; 6 state plans encompassed all 3 core functions. Plan coordinators indicated that genomics is a low priority in state public health; barriers to incorporation included lack of sufficient staff and funding. ConclusionIncorporation of genomic terms into state CCC plans increased from 60% in 2005 to 94% in 2010, but according to plan coordinators, genomics has not grown as a priority. Identification of partnerships and resources may help increase the priority, encourage incorporation, and guide the eventual success of public health genomics in state plans. Strong partnerships with state public health departments, health care providers, and the research community are useful for integration.
Highlights
Introduction Comprehensive CancerControl (CCC) plans address cancer burden at the state level through consolidation of activities and collaboration among stakeholders
Incorporation of genomic terms into state Cancer Control (CCC) plans increased from 60% in 2005 to 94% in 2010, but according to plan coordinators, genomics has not grown as a priority
The objectives of this study were to assess the extent to which CCC plans have incorporated genomics-related terms since 2005, determine which of the 3 core public health functions were fulfilled by the genomics components, and identify facilitators and barriers to integration of genomics
Summary
The objectives of this study were to assess the extent to which CCC plans have incorporated genomics-related terms since 2005, determine which of the 3 core public health functions were fulfilled by genomics components, and identify facilitators of and barriers to integration of genomics. Single -gene genomic applications, such as cascade testing for Lynch syndrome, have a potential effect in cancer prevention in high-risk families [5]. The fundamental tool of genomics — collecting family history — is a low-cost and effective method to identify people at increased risk and to promote evidence-based screening [5]. The 3 core functions of public health are assessment, the collection and dissemination of data; policy development, the creation of standards; and assurance, ensuring quality and accessibility of services [6]. A survey of public health and laboratory officials in 2001 identified that assurance was the most common function of public health genomics (82%); the investigators predicted more balance among the 3 functions [7]
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