In 2020, an estimated four million people in Europe received a cancer diagnosis. Cancer develops when certain cells in the body start to grow and divide in an uncontrolled way. Over recent years, research has shown that changes or variants in our genes often play a key role in driving this process.
Genetic testing can help determine whether these genetic changes were present in someone’s genome from birth or whether they developed later in life.
When a genetic variant is present from birth, it can increase a person’s lifelong risk of developing certain cancers, such as breast or ovarian cancer. Because this type of genetic variant can be passed on, it may also affect parents, siblings and future children. For patients, understanding this inherited risk can guide decisions about the most suitable treatment and follow-up, and may also inform reproductive decisions. For relatives, this information can also be relevant, helping guide decisions about screening, preventive treatments or lifestyle changes. At the same time, the family relevance of genetic information raises difficult questions about how, when and whether to share this information within families. For many people, this can be emotionally challenging, and careful genetic counselling is important to support communication and decision-making.
Not all genetic variants are inherited. Some occur later in life, for example, through ageing or exposure to environmental factors. These variants are not passed on to children. Even so, knowing the specific genetic features of a tumour can be very useful. Certain genetic characteristics can help doctors select treatments that are more likely to be effective, or estimate how a tumour may behave over time. This makes it possible to tailor care more closely to the individual and supports more personalised and targeted treatment.
While personalised treatments can offer important benefits, some (like certain forms of immunotherapy) can be very costly or are not yet covered by national healthcare systems. As a result, they may not be accessible to everyone. Participation in clinical trials can sometimes provide access to new therapies. Yet, trials are not always available to all populations, and benefits are not guaranteed.
These challenges highlight the importance of continuing discussions on the ethical and societal aspects of personalised treatment along with scientific progress, to help ensure that advances in care are informed, fair and accessible.
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