Little-used cancer test shows poor preparedness for genetic cost- and life-savers

(Bloomberg) — Genetic testing is becoming cheaper and more widespread, promising to usher in a revolution in cancer treatment. Yet, long-standing DNA tests are often overlooked for reasons including doctors’ ignorance and financial incentives discouraging companies from marketing them.

As scientists predict DNA testing will transform medicine, doctors and hospitals are ignoring existing tests that could help prevent thousands of cancer deaths, not just of their own patients, but in generations to come.

Busy primary-care doctors, who typically have little training in genetics, don’t see the warning signs in patient family histories and don’t refer those at risk to a genetics expert. Testing companies don’t advertise and market some DNA tests as much as they do more lucrative tests for breast cancer genes, says patient advocate Linda Bruzzone.

This failure to incorporate genetic knowledge into routine prevention and treatment of diseases like colorectal cancer — the second-most common cause of cancer death in the United States — shows how hard it is to bring the benefits of the genome to patients.

“No company has enough of the market share to make it worthwhile to invest in education of doctors and patients,” Bruzzone says. “Without a strong base, you can’t get anything done.”

However, Mark Capone, president of Salt Lake City-based Myriad’s genetic-testing unit, blames complicated medical guidelines for Lynch syndrome tests, often involving a two-step testing process, and low patient awareness of colon cancer for underuse of the test. Further, Kurtis Glade, marketing director for Ambry Genetics, says awareness of many genetic tests is relatively low among physicians.

“We’re working to close that gap as much as we can with education,” Glade says.

Doctors typically learn about new tests through a combination of scientific studies showing tests save lives, recommendations from specialist groups and marketing and education sponsored by testing companies.

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