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Genomics Implementation

More Detailed Information on Key Tier 1 Applications - Lynch Syndrome

Phase 2 LS Approaches

Cascade Screening

States that have achieved successes in Phase 1 implementation can build upon their established partnerships with providers and payers by facilitating LS cascade screening pilot projects.  Cascade screening is an active process to find relatives of persons affected with certain genetic conditions at a pre-symptomatic stage because interventions exist that can save lives. LS Phase 2 efforts can be designed using a population-based, state-wide approach or could be initially based out of one large payer/provider network.  However, Phase 2 efforts – even more passive designs – are complex and require more resources, expertise, and partnership development than most states are ready for at this time.  Because families can no longer be assumed to cluster within towns, cities or even states, cascade screening will require coordination across states, further complicating the challenges.  However, the potential rewards for trail blazing states in a position to successfully conduct cascade screening are great.

Example: Ohio  The Ohio Statewide Lynch Syndrome Screening Initiative:  The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Institute have launched a statewide initiative to screen newly diagnosed CRC patients and their biological relatives for LS. The effort will identify relatives who may be at risk of developing these cancers so that they can take precautionary measures. The Ohio Colorectal Cancer Prevention Initiative includes 42 hospitals throughout Ohio that will implement the LS screening program at their own institutions. They will advise patients and their physicians of the results, offer genetic counseling and make high-risk cancer surveillance recommendations to patients and family members found to have LS.

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