Organizing cancer genetics programs: The Swiss model

Purpose: Inherited predisposition to cancer is a complex issue, and risk as sessment, counseling, and management are multidisciplinary tasks. An infras tructure is needed through which clinical services may be delivered and res earch activities conducted. Methods: The Swiss Institute for Applied Cancer Research (SIAK) Network for Cancer Predisposition Testing and Counseling was established in 1999. The goals of the Network are to set common standards for clinical services, to coordinate research activities, to address psychosocial and ethical issues concerning genetic counseling and testing, and to translate the knowledge g ained into medical practice. Results: An algorithm for genetic testing and counseling of the families st udied by the SIAK Network centers has been established in a consensual proc ess. Eight regional centers currently operate according to this algorithm. Furthermore, a proposal has been submitted for the setup of a Swiss databan k for the characterization of BRCA1 and BRCA2 mutation patterns and the ide ntification of potentially unique mutations in probands who seek genetic co unseling and testing at the respective centers of the SIAK Network. Conclusion: Our coordinated effort will ensure state-of-the-art genetic tes ting and counseling services in Switzerland and will allow us to acquire kn owledge for appropriate risk assessment and surveillance/prevention strateg ies for individuals with an inherited cancer predisposition. (C) 2000 by Am erican Society of Clinical Oncology.