Translating genomic evidence into action strategies to save lives now

While genomic research has generated an ever-increasing array of tests and personalized interventions, genomic applications other than newborn screening continue to play a relatively minor role in public health practice. Yet, a growing number of life-saving, evidence-based genomic applications are now suitable for implementation by public health agencies in partnership with clinicians, laboratories, insurers and community-based organizations. As budget constraints force public health agencies to concentrate on interventions with proven capacity to save lives and prevent disease, public health practitioners need to be aware of evidence-based genomic strategies that should be included among these priorities. This presentation describes three genomic interventions that are ready for “prime time”. They utilize family health history and cascade screening to prevent hereditary breast and ovarian cancer, Lynch Syndrome and familial hypercholesterolemia. We will report on a recent national conference that developed action strategies essential to implement these three programs effectively, drawing upon the expertise of leaders in public health, health care and community domains. Applying the familiar framework of public health essential services, the conference identified nine components of these three action plans that will assure their effectiveness. These involve partnership development and community mobilization, education of providers and the public, surveillance and evaluation to measure effectiveness, and policy development to address funding issues, data gathering and protection of privacy. Effective implementation of these three interventions can generate models for translating a growing number of evidence-based genomic applications into public health programming, enabling genomics to play an increasing role in achieving public health goals.