This work was completed with publication of our report Stratified screening for breast cancer. We are now investigating the future of Personalised prevention in breast cancer, also funded by the EC as part of its B-CAST collaboration.
The PHG Foundation had been leading a work package to examine the potential for risk stratification of populations and targeted screening based on genetic information, as well as factors relating to implementation such as cost-effectiveness, ethical, legal and social issues.
COGS (the European Commission funded Collaborative Oncological Gene-environment Study) is a multi-centre international project with multiple work packages. Its aims are to:
- Define individual risk of breast, ovarian and prostate cancers based on lifestyle factors and genetic variants
- Improve identification of people at increased risk of these cancers
- Prevent disease
As part of the project, our team has co-authored a review in Genetics in Medicine on the implications of incorporating genomics into cancer screening. The review is accompanied by a commentary and overview of the topic by the CDC's Muin Khoury and colleagues. You can read them both here:
- Incorporating genomics into breast and prostate cancer screening: assessing the implications
- How can polygenic inheritance be used in population screening for common diseases?
Little attention has so far been given to the implementation of stratified screening. This article reviews the issues that would arise in delivering such tailored approaches to prevention in practice.
The first publication from this workstream suggests that using genetic data could improve population screening for breast and prostate cancers.
Other outputs from COGS include:
- Time to revisit Geoffrey Rose: strategies for prevention in the genomic era?
Hilary Burton, Gurdeep S Sagoo, Paul Pharoah, Ron L Zimmern (Published: Italian Journal Public Health)
- What ethical and legal principles should guide the genotyping of children as part of a personalised screening programme for common cancer?
Alison Hall, Susmita Chowdhury, Nina Hallowell, Nora Pashayan, Tom Dent, Paul Pharoah and Hilary Burton
(In press: Journal of Medical Ethics)
The Collaborative Oncological Gene-environment Study (COGS) is a project funded by the European Commission and 7th Framework Programme under grant agreement 223175 (HEALTH-F2-2009-223175). For more information, see www.cogseu.org