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Advertising genetic testing. (letters).

To the Editor: As an oncologist and clinical investigator, I wish to echo the major concerns described by Hull and Prasad in their excellent commentary regarding direct advertising of genetic testing to the public (HCR, May-June 2001). Anyone who believes that the results of genetic testing, or even that records showing testing was performed, will remain out of the hands of insurance companies or employers, has not spent any time in the modern hospital environment. Further, many health insurance companies mandate that patients agree to require hospitals and physicians to make available any information relevant to their medical status, which clearly could include results of genetic testing.

In addition, while currently available data suggest a role for prophylactic bilateral mastectomies in women with a documented high risk of breast cancer, no such statement can be made regarding any protective effect from ovarian cancer following removal of the ovaries. Since the entire lining of the abdominal cavity is at risk for the development of a disease process (primary peritoneal carcinoma) that is essentially identical to ovarian cancer, it remains questionable how much benefit (if any) will result from simple removal of the ovaries in women with a substantially increased lifetime risk of malignant transformation of this normal tissue.

If this were a "more perfect world," and commercial interests had to present more objective and balanced information regarding their products, it would be my suggestion that the clear and succinct analysis provided by Hull and Prasad should be required reading (like an IRB consent form) by all women who consider obtaining this genetic test. Once the genie is out of the bottle, it can't be put back in.
Maurie Markman
The Cleveland Clinic Taussig
Cancer Center
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Author:Markman, Maurie
Publication:The Hastings Center Report
Article Type:Letter to the Editor
Date:Nov 1, 2002
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