GINA
In May of this year, President Bush signed a bill into law that really didn’t receive much in the way of headlines or fanfare. This was the so called GINA law, which is a law that finally makes it illegal for employers or health insurance companies to discriminate against patients based on their genetic information. This is an incredibly important piece of legislation and I feel is long overdue in this country. Genetic testing is becoming much more frequent and much more widely done. More & more patients are having to deal with the idea that an underlying genetic abnormality is a possible root cause of their cancer or other disease. They also have to deal with the idea that these abnormal genes can be passed on to their children. The most well-documented and well-developed area is in the realm is in breast cancer. The BRCA-1 & 2 genes have been known and identified for at least the last decade and it is becoming more & more common for patients to be tested for these genes. Being positive for these genes has significant ramifications for patients and their offspring’s both in terms of management of their breast cancer and their increased risk for other types of cancer, such as ovarian cancer.
Breast cancer isn’t the only area that genetic abnormalities have been found; patients and families with high incidence of colon cancer are tested. There are also genes that increase the risk of melanoma. I suspect that over the next 5 to 10 years multiple new genes will be identified that provide information on a patient’s risk of developing certain types of cancers. This is an important fundamental shift in the way that we look at cancer. If we can truly identify patients that are at a significantly higher risk, we can then consider increased surveillance, prevention and possibly reduce the overall incidence of cancer. At the same time, it is scary for patients to have an abnormal gene found & identified in themselves and in their children. Hopefully the passing of the GINA law will relieve some of the patients’ anxiety. I believe that congress and the president got this one right.
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