Strategic Objective 1: Maximising cancer prevention and early detection

5-year goal
Action 1.5.4

Develop a policy framework for genomics in cancer control across the cancer care continuum.

Some Australians are more at risk of developing cancer than others. Genetic testing, which is a type of test that identifies a change in a person’s chromosomes or genes, is an emerging opportunity to better identify individual risk as part of cancer prevention and early detection.[118] This information can be used to determine predisposition to certain cancers by detecting cancer-related genetic alterations (such as BRCA mutations which are associated with an increased risk of developing breast cancer, ovarian cancer and certain other cancers).

Identifying individuals at increased risk of developing cancers or cancer recurrence can support preventive interventions and earlier detection. This has significant potential to reduce the prevalence of later stage cancers, particularly among high-risk individuals, and improve overall survival rates.

Genomic tests can help determine mutations in genes that drive various cancer behaviours; from how aggressive the cancer may be to whether it is likely to spread and how it will respond to treatment.[119]

By studying genes and other genetic information, their functions, and how they interact with each other and with the environment, genomics may lead to new ways of understanding how cancer forms and to prevent, diagnose, and treat cancer more effectively.

Genetic and genomic testing technologies are being continually enhanced and becoming more precise, cost-effective and accessible.

Developing a national policy framework for genomics in cancer control across the cancer care continuum has the potential to promote a common understanding of this technology, drive its safe and effective application in practice, foster collaboration and provide future direction for its integration and use within the cancer care system.

A policy framework may also provide guidance on the importance and requirements of genomic testing infrastructure, implementation of best practice and culturally and medically appropriate aftercare (including routine access to genetic counselling), funding, quality and safety and considerations of the ethical, privacy, Indigenous Data Sovereignty and workforce challenges in incorporating genomics information into cancer care. The framework should also include the need for ongoing monitoring of the benefits and cost-effectiveness of genetic and genomic testing for cancer prevention, early detection and care.

Collaboration with the research and university sector across jurisdictions and states will ensure that the delivery and development of genomic screening is evidence-informed, consistent and accessible.

Stakeholder Quotes

The Australian Cancer Plan needs to enable personalised approaches to prevention and early detection through genomic testing to identify and mitigate personal risk
Public Consultation Submission
The Australian Cancer Plan needs to enable personalised approaches to prevention and early detection through genomic testing to identify and mitigate personal risk
Public Consultation Submission
The current extent of genomic testing being conducted in Australia is unknown … we need an overarching national strategy
Public Consultation Submission
Equitable access to high quality and cost-effective genomic testing to support clinical practice should be affordable and sustainable for Australian taxpayers
Public Consultation Submission

Implementation Considerations

Aboriginal and Torres Strait Islander people
Adolescents and Young Adults
Children
People from Culturally and Linguistically Diverse (CALD) Backgrounds
People living with Disability
People in Lower Socioeconomic Groups
Older Australians
People Living in Rural and Remote Areas
  • Policy framework co-designed with Aboriginal and Torres Strait Islander people to ensure cultural safety and ethical implications of genetic research and genomic technology are addressed.
  • Reinforce conventions on the protection of genetic information of Aboriginal and Torres Strait Islander people and Indigenous Data Sovereignty.

Aboriginal and Torres Strait Islander people

  • Policy framework co-designed with Aboriginal and Torres Strait Islander people to ensure cultural safety and ethical implications of genetic research and genomic technology are addressed.
  • Reinforce conventions on the protection of genetic information of Aboriginal and Torres Strait Islander people and Indigenous Data Sovereignty.

Adolescents and Young Adults

  • Policy framework to include direction on engagement with adolescents, young adults, and their families on the importance of genetic screening for predicting future disease status and susceptibility to certain cancers, such as breast and ovarian cancer.

Children

  • Policy framework to include direction on engagement with, and inclusion of, children and their families and carers.
  • Policy framework to include direction on the screening of acquired and mutated genes common among children with cancer and how to seek parental consent in the delivery of genetic testing.

People from Culturally and Linguistically Diverse (CALD) Backgrounds

  • Policy framework to include direction on engagement with people from diverse backgrounds, including a strategy for ensuring communications and applications for genomic testing are accessible and available in a wide variety of languages (including processes of informed consent).

People living with Disability

  • Policy framework to include the interactions between genetic and genomic testing for cancers with those for other chronic illnesses or disabilities.

People in Lower Socioeconomic Groups

  • Policy framework to include direction on how this technology will be cost-effective and accessible to all Australians irrespective of income or the area in which they live and ensure no or minimal out-of-pocket expenses for consumers including their carers and families.

Older Australians

  • Policy framework to include direction on appropriate testing for older Australians, including a model of engagement for seeking consent from older Australians, their families or carers, and the role of genomic testing alongside existing population-wide screening programs with aged-based eligibility requirements.

People Living in Rural and Remote Areas

  • Policy framework to include accessibility and how this technology will be made available beyond metropolitan areas.
  • Policy framework to include scalability and equity in access for all Australians, regardless of location.

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