Genetic counselling for familial breast and ovarian cancer in Ontario.

Advances in molecular medicine and increasing attention of the media to clinical developments in genetics have spurred the demand for genetic counselling services for several conditions, most notably for hereditary cancers. 2 Genetic counsellors in the Canadian province of Ontario serve a population of 11.7 million, of whom approximately 85% live in urban areas and 15% live in rural areas. The costs of most genetic counselling and related health activities in Ontario are covered by the provincial health plan (OHIP). In almost all cases, block funding is provided by the Ontario Ministry of Health to support genetic counselling services in the hospital setting. There are no private genetic services offered and there is no patient co-payment. Currently, special funds are allocated for cancer genetics services, in addition to funds provided for other genetics services, although an individual genetic counsellor may provide services in both domains. We conducted a descriptive survey of genetic counselling activities in 27 centres in Ontario, Canada to determine the relative distribution of genetic consultations by medical condition, under the current health care system.