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Inégalités sociales et médecine prédictive: quels enjeux en oncogénétique ?

Abstract : The technical developments in genetic research allow, since the end of the 90s, to approach the concept of predictive medicine. The tests of genetic predisposition of cancers, emblem of this predictive medicine, are accessible at the end of consultations of oncogénétique. This activity took a considerable development in France with today more than 36 000 annual consultations on 107 sites distributed in 76 cities, in particular thanks to the plans cancer which registered the necessity of favoring an access to the consultations and to the genetic tests.BRCA1 and BRCA2 genesare the genes most often involved in genetic predispositionin breast andovarian cancers. Women with an anomaly on one of these 2 genes have a risk of developing a breast cancer, during their life, close to 80 % and a risk of the ovarian cancer from 20 to 30 %. The care of these persons at high risk is complex and rests on the screening and on the possibility of preventive surgery. The consultation aims at informing and at accompanying the consultant, with or without personal history of cancer, in their choices of care. These choices rest on the understanding of a complex information including the notions of risks, trans-generational transmission and heredity.The clinical experience allows to notice the heterogeneityof access to the consultation, preventive appropriation of the information and the follow-up of the measures according to the social circles of the consultants and their families. From clinical cases ofcarriers of BRCA1 / 2 mutations, we shall describe and shall discuss the various elements which can interact with the notion of social inequality by making way to individuals, families, histories. But we shall also discuss socioeconomic consequences and social inequalities inferred by the family trouble of cancer and by the status of persons at risk.
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Laetitia Huiart. Inégalités sociales et médecine prédictive: quels enjeux en oncogénétique ?. Expressions, Institut universitaire de formation des maîtres (IUFM) Réunion, 2013, Actes des 2ndes journées de rencontre : "Inégalités sociales, santé, éducation", pp.1-8. ⟨hal-02388575⟩

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