The number of consultations to diagnose genetic mutations that cause cancer is increasing, but waiting times are getting longer.
Genetic predispositions are responsible for around 5% of cancers diagnosed in France. The National Cancer Institute (INCa) publishes this week a balance sheet on the system put in place to better detect the genetic mutations responsible for these diseases in individuals at risk.
Since the beginning of the 2000s, a large network of oncogenetics consultations and laboratories has been set up to support physicians in this task.
130 places in 90 cities now welcome cancer patients and individuals whose family history predisposes them to cancer. 25 laboratories complete the system, the idea being to identify the presence of potentially dangerous genetic mutations.
More consultations
The year 2014, which is the subject of the report, represents a positive turning point in the field of oncogenetic diagnosis. Over the past twelve years, the number of consultations offered has steadily increased.
In 2014, this represents an increase in activity of 18% compared to the previous year. Concretely, 23,635 people were seen in consultation that year, whereas in 2013, they were just over 20,000, and nearly 18,000 in 2012.
Among the cancers most affected by the oncogenetic discipline, that of the breast and ovaries, and Lynch syndrome, a particular form of colorectal cancer. In these three pathologies, 2 to 5% of cases are linked to genetic factors.
For breast and ovarian cancers, the genetic mutations most often implicated concern the BRC1 and BRC2 genes, but also the PALB2 gene. For Lynch syndrome, four genes are mainly affected: MLH1, MSH2, and less frequently, MSH6 and PMS2.
In both cases, the number of consultations offered increased by 22% in one year, between 2013 and 2014.
Extended waiting times
On the other hand, the waiting times to obtain an appointment in an oncogenetics consultation have increased. Today, it takes 13 weeks (median time) before a person is offered an interview. This corresponds to an extension of four to five weeks compared to 2013.
Labs that perform the tests for genetic mutations have also increased their delay, at least for Lynch syndrome. Patients had to wait an average of 31 weeks, 10 more than in 2013, to have their results.
According to the report, this was due to the introduction of new diagnostic techniques that the teams had to get used to.
On the other hand, the results of the tests carried out to detect the BRC1 and BRC2 mutations were delivered more quickly in 2014, in 33 weeks, that is to say three less than the previous year.
A contrasting assessment therefore, but which nevertheless allowed the detection of more than 49,000 people carrying mutations predisposing them to cancer. Enough to ensure more effective care.
Anticipate and personalize
In the event of a genetic mutation, patients can turn to 17 regional programs whose goal is to establish extensive personalized monitoring for each of the individuals at risk.
Coordinated at the regional level, with easy access to multidisciplinary skills and various expertise, such monitoring makes it possible to anticipate the potential onset of the disease, for example by having recourse to preventive surgeries.
.
