ABSTRACT
Introduction: The SCAN cancer genetics workgroup aimed to develop Singapore Cancer Network (SCAN) clinical practice guidelines for referral for genetic evaluation of common hereditary cancer syndromes.
Materials and Methods: The workgroup utilised a modified ADAPTE process to calibrate high quality international evidence-based clinical practice guidelines to our local setting. Results: To formulate referral guidelines for the 3 most commonly encountered hereditary cancer syndromes to guide healthcare providers in Singapore who care for cancer patients and/or their family members, 7, 5, and 3 sets of international guidelines respectively for hereditary breast and ovarian cancer (HBOC) syndrome, Lynch syndrome (LS), and familial adenomatous polyposis (FAP) were evaluated. For each syndrome, the most applicable one was selected, with modifications made such that they would be appropriate to the local context. Conclusion: These adapted guidelines form the SCAN Guidelines 2015 for referral for genetic evaluation of common hereditary cancer syndromes.Mutations in high penetrance genes account for approximately 3% to 5% of all cancers. In the last 2 decades, there has been better characterisation of an ever growing list of hereditary cancer syndromes, largely due to the identification of causative genes. Formal management guidelines, including testing, screening and preventive options, have been established for many of these syndromes. Identification of these patients and families who are at extremely high risk of developing cancer for specialised management is crucial to reduce cancer occurrence and mortality. Formal cancer genetics programmes have been established in Singapore in both tertiary cancer centres in Singapore (National University Cancer Institute [NCIS], National Cancer Centre [NCCS]) since 2001. However, there are no formal local guidelines providing guidance to general practitioners, physicians or surgeons on who should be referred for cancer genetic assessment
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