Abstract
In 2011, the Division of Cancer Prevention and Control (DCPC), at the United States Centers for Disease Control and Prevention (CDC), released a three-year funding opportunity announcement (FOA) for a competitive, non-research cooperative agreement. The agreement enhanced the capacities of state health departments to promote the application of best practices for evidence-based breast cancer genomics through education, surveillance, and policy activities. The FOA required that applicants focus on activities related to hereditary breast and ovarian cancer (HBOC). The DCPC funded three states: Georgia, Michigan, and Oregon. Georgia was a first-time recipient of cancer genomics funding, whereas Michigan and Oregon had long standing activities in cancer genomics and had received CDC funding in the past. By the end of the funding period, each state had well-functioning and impactful state-based programs in breast cancer genomics. This article highlights the impact of a few key state activities by using CDC’s Science Impact Framework. There were challenges to implementing public health genomics programs, including the need to develop relevant partnerships, the highly technical nature of the subject matter, a lack of genetic services in certain areas, and the difficulty in funding genetic services. Georgia, Michigan, and Oregon have served as models for others interested in initiating or expanding cancer genomics programs, and they helped to determine what works well for promoting and integrating public health genomics into existing systems.
Highlights
Breast Cancer Susceptibility gene (BRCA) mutations are estimated to occur in 1 in 300 to 500 women in the general population [1,2,3,4]
This funding opportunity announcement (FOA) was intended to enhance the capacities of state health departments to promote best practices for evidence-based breast cancer genomics by using education, surveillance, and policy
To describe outcomes of the cancer genomics FOA, the Division of Cancer Prevention and Control (DCPC) traced the impact of key state education, surveillance, and policy activities by using Centers for Disease Control and Prevention (CDC)’s science impact framework [18] illustrative examples from each state are presented here (Table 1)
Summary
Breast Cancer Susceptibility gene (BRCA) mutations are estimated to occur in 1 in 300 to 500 women in the general population [1,2,3,4]. There are evidence-based clinical recommendations on hereditary breast and ovarian cancer risk assessment, genetic counseling, and genetic testing in the United States [11,12], there are few evidence-based programs that promote or implement these clinical recommendations at a population level. Services Task Force (USPSTF) has recommended that women at high risk of developing Hereditary Breast and Ovarian Cancer (HBOC) should be referred for genetic counseling and evaluation for genetic testing. Women at low risk of developing HBOC should not be referred for such services [11,13] Despite these recommendations, there are few coordinated public health cancer genomics programs in the United States. We describe the activities and impact of CDC-funded programs for breast and ovarian cancer genomics
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