Costs, benefits and limitations of genetic testing for cancer risk

There has been considerable progress in the identification of predisposing genes involved in many of the rare familial cancer syndromes and in a proportion of the common cancers. Genetic testing for cancer risk is now part of good medical practice in a number of cases, allowing specific cancer screening and prevention to be targeted to those with the greatest need. In some situations, the advantages of testing are less obvious, and careful evaluation of the costs and benefits of testing, and the efficacy of any subsequent intervention, is essential. In the meantime, it is clear that structures must be set up to evaluate demand for testing and deal with it; to inform and educate the public and doctors so that demand is based on understanding of what genetic tests can do; to provide action on test results and to advise and support individuals before and after testing.