Cancer Risk Assessment and Screening; A Challenge for Clinical Pathology Service?

Siti Boedina Kresno

Abstract


There is evidence demonstrating that cancer etiology is multi-factorial and modification of risk factors has achieved
cancer prevention. There is therefore a need to advance the understanding of cancer etiology through interaction effects
between risk factors when estimating the contribution of an individual to the cancer burden in a population. It has been
known that cancer may arise from genetic susceptibility to the disease as an intrinsic factor; however, non-intrinsic factors
drive most cancer risk as well and highlight the need for cancer prevention. Are our clinical pathologists aware of these
facts?. Are they ready to understand and to provide an excellent test with good expertise?. Hereditary cancer testing is
typically performed using gene panels, which may be either cancer-specific or pan-cancer to assess risk for a defined or
broader range of cancers, respectively. Given the clinical implications of hereditary cancer testing, diagnostic laboratories
must develop high-quality panel tests, which serve a broad, genetically diverse patient population. The result will determine
a patient's eligibility for targeted therapy, for instance, or lead a patient to prophylactic surgery, chemoprevention, and
surveillance. This review will introduce the definitions of intrinsic and non-intrinsic risk factors, which have been employed in
recent work and how evidence for their effects on the cancer burden in human subjects has been obtained. Genetic testing
of cancer susceptibility genes by use of liquid biopsies and New Generation Sequencing (NGS) is now widely applied in
clinical practice to predict the risk of developing cancer, help diagnosis, and treatment monitoring.


Keywords


Cancer risk factors, intrinsic, non-intrinsic, gene variants, multi-panel gene testing

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DOI: http://dx.doi.org/10.24293/ijcpml.v27i1.1660

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