Insights from 25 years of oncogenetics: one person's perspective

In early 1995, I established the oncogenetics service at the Genetics Institute of the Sheba Medical Center in Israel. The purpose of this article is to describe the key points and issues that were raised throughout my personal journey since then: physician and public awareness; ethical and legal issues; guidelines for oncogenetic counseling; the development of oncogenetic testing within the unique Israeli reality of the limited spectrum of BRCA1 and BRCA2 mutations; high-risk vs. population screening; and the definition and implementation of guidelines for surveillance of asymptomatic mutation carriers. Since 1995, oncogenetics has been transformed from a rare oddity to a pivotal player, and it represents a successful example of implementing personalized preventive medicine by identifying and providing care and by offering means for early detection and risk reduction for adults who are genetically predisposed to develop a potentially life-threatening disease-cancer in this case. Lastly, I outline my personal vision for the possible way forward for oncogenetics.

Automated summary

This article describes the key points and issues encountered in my journey of establishing the oncogenetics service at the Sheba Medical Center in Israel, including physician and public awareness, ethical and legal issues, guidelines for oncogenetic counseling, the development of oncogenetic testing within the limited spectrum of BRCA1 and BRCA2 mutations in Israel, high-risk versus population screening, and surveillance guidelines for asymptomatic mutation carriers. Oncogenetics has evolved from a rare oddity to a pivotal player in personalized preventive medicine, offering early detection and risk reduction for genetically predisposed individuals. Lastly, the article outlines the author's personal vision for the future of oncogenetics.