The Front Line of Genomic Translation

Copyright © 2012 Suzanne C. O'Neill et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Cancer prevention, detection, and treatment represent the frontline of genomic translation. Increasingly, new genomic knowledge is being used to inform personalized cancer prevention recommendations and treatment [1–3]. Genomic applications proposed and realized span the full cancer continuum , from cancer prevention and early detection vis a vis genomic risk profiles to motivate behavioral risk reduction and adherence [4] to screening and prophylactic prevention recommendations for high-risk families [5–7], to enhancing cancer survivorship by using genomic tumor profiles to inform treatment decisions and targeted cancer therapies [8, 9]. Yet the utility for many of these applications is as yet unclear and will be influenced heavily by the public's, patients' , and health care providers' responses and innu-merous other factors, such as health care delivery models [3]. The contributors to this special issue consider various target groups' responses and contextual factors. To reflect the cancer continuum, the special issue is divided into three broad, overlapping themes—primary prevention, high risk families and family communication and clinical translation. The issue begins with three papers that consider applications of genomic information to promote the primary prevention of cancer. Hay and colleagues present results of a randomized trial evaluating prototypic genetic risk feedback with first degree relatives of patients with melanoma. Using an experimental pre-post design, the authors tested whether varied feedback type (high risk mutation, gene-environment, nongenetic) and risk level (positive versus negative findings), all emphasizing the importance of family history regardless of feedback type, influenced families' risk perceptions, and behavioral intentions. Findings indicated that risk level, but not feedback type, was associated with higher perceived risk and behavioral intentions for sun protection and skin screening. It is widely acknowledged that efforts should be directed to building an evidence base to inform genomic risk communication practice. This will be essential as new technologies such as whole genome sequencing begin to yield voluminous amounts of risk information for providers, patients and their families. Thus unpacking the essential elements of effective risk communications could facilitate translation of emerging and increasingly complex genomic risk information. Rutten and colleagues used data from the 2008 and 2011 waves of the Health Information National Trends Survey (HINTS), a nationally representative sample, to assess …