[Predictive genetic testing for hereditary breast cancer and hereditary nonpolyposis colorectal cancer]

Genetic tests are no longer used exclusively for diagnostic purposes, but they serve in increasing numbers to assess the predisposition for illnesses. Predictive genetic testing of this kind includes screening for genetic predispositions towards tumours. Of special significance are familial breast and ovarian cancer caused by BRCA1 - and BRCA2- mutations and hereditary nonpolyposis colorectal cancer (HNPCC). The observation of such conditions constitutes a considerable burden for the individuals concerned as well as their families. So far it has not been sufficiently established to what extent methods of prevention and early diagnosis can offer effective protection against the risk of tumours. While prophylactic organ resections lower the morbidity and mortality associated with cancer, they are also responsible for a loss of physical and emotional well-being. Therefore, an awareness of hereditary predispositions towards tumours causes considerable need for competent medical advice and clinical research. Interdisciplinary projects can offer the suitable organisational base for these tasks. Doctors, universities and health insurances are faced with the challenge of developing and financing corresponding structures of medical care and research.