The Ethics of Genetic Testing for Inherited Cancer-Predisposing Genes

Area of Science:

• Medical Genetics
• Oncology
• Bioethics

Background:

• Identifying carriers of inherited cancer-predisposing genes or pathogenic germline variants (PGVs) allows for early cancer detection and prevention.
• Genetic testing offers significant health benefits and information to patients and their families.

Purpose of the Study:

• To consider the ethical question of whether all patients have a right to germline testing for cancer-predisposing PGVs.
• To review the historical debate surrounding universal germline testing, including analytical sensitivity, legal, cost, and management implications.

Main Methods:

• Ethical analysis of the right to genetic testing.
• Review of existing literature and standard of care guidelines for germline variant testing.

Main Results:

• Current standard of care involves offering testing when benefits outweigh harms.
• Past debates focused on test accuracy, legal issues, healthcare costs, and management uncertainties.

Conclusions:

• The ethical considerations of universal germline testing for cancer predisposition warrant careful examination.
• Balancing potential benefits against harms remains central to current testing protocols.