Clinical Genomics Program

From disease prevention to diagnosis to treatment, genomics is the future of medicine. Genomics will be an essential component of health care not just for the individual, but for our greater community as we focus on wellness and preventative care. The implications of genomics programs are significant for today’s patients, and importantly, the future of Florida’s health.

AdventHealth is implementing clinical pilots within mammography appointments, colonoscopy appointments, and primary care appointments to provide the benefits of personalized and preventative care with the goal to expand the programs across AdventHealth. With any new initiative or technology, we test it in a small population and see how the community responds before expanding to the whole organization.

Adults (18-70) who are scheduled for a mammography appointment, colonoscopy appointment, and/or primary care appointment at one of our pilot locations/clinics within AdventHealth. Once you have an appointment at one of these locations, you will receive an email to complete a cancer risk assessment survey. This is the first step in the program.

You will receive an email from Volpara Health (sent on behalf of AdventHealth). You will need to enter your date of birth to access your personal cancer risk survey. Please complete your survey before your scheduled appointment (either colonoscopy or mammography). Our care navigator will reach out after your appointment with your results and potential next steps if you are at higher-than-average risk for hereditary cancer.

Once you complete your survey, our care navigator will reach out with your results. If you are at low risk, you will continue completing your screenings, as prescribed by your health care provider. If you are at higher-than-average risk, you could be referred to our genetic counselors who will discuss genetic testing and/or you could be referred for additional tests such as ultrasounds or biopsies.

It’s well established that having pathogenic variants in BRCA 1/2 (and other genes) puts individuals at a much higher risk of developing hereditary cancers, primarily breast and/or ovarian cancers. Likewise, it’s well established that there are several genes associated with a higher risk of developing gastrointestinal and/or colorectal cancer, including the Lynch syndrome. Those with Lynch syndrome are also at a higher risk of developing other cancers, such as uterine, stomach, liver, kidney, and brain cancers, at a young age (<50 years old).

Early detection of cancer is associated with better health outcomes and lower cost of care to the patient. Additionally, if genetic testing shows that a patient has a higher chance to develop cancer, the patient has the opportunity to alert first-degree relatives (such as parents, children, siblings) to let them know about their potential to carry the same hereditary cancer predisposition syndrome.

If you are found to have a hereditary predisposition to develop breast cancer, each of your children will have a 50 percent chance of having it.

If the DNA analysis testing is ordered by the physician(s) involved in your care, you will be billed in the same manner as you would with any other lab tests that are medically recommended and ordered by the physician(s) involved in your care.

A majority of patients typically pay $100 or less (out of pocket). If you have a high deductible or are self-pay, the genetic testing self-pay price is around $250. Most laboratories have patient assistance programs if you cannot afford this cost.

A federal law called the Genetic Information Nondiscrimination Act (GINA) makes it illegal for health insurance companies, group health plans, and most employers to discriminate against you based on your genetic information, but GINA does not apply to life insurance, long-term care insurance, or disability insurance. More information about GINA is available at http://www.genome.gov/.

There is also Florida law that prohibits your genetic information from being used to grant or deny certain insurances, employment, mortgage, loan, credit or educational opportunities. However, a diagnosis made from your DNA analysis test results may have an effect on your access to certain insurance or insurance rates. For example, a life insurance company may consider a medical diagnosis in your medical record, even if the diagnosis was based on the results of a DNA analysis. Please know that AdventHealth and your physician(s), as your health care provider, will not use your genetic information for any of these purposes. Laws against genetic discrimination may not apply to the military.

Your family is protected by the Genetic Information Nondiscrimination Act (GINA).

No, we are not going sell your DNA to other companies.

Your DNA analysis test results and other health information about you may be used and shared with others as allowed by federal and state privacy laws for:

• Treatment you receive from healthcare providers.
• Payment to AdventHealth, your physician(s) and the laboratory by health plans or other payers for your treatment.
• Health care operations of AdventHealth, your physician(s) or the laboratory. For example, health care operations include reviewing what went well with your treatment and what needs to be improved, as well as creating de-identified information that may be used and shared with others as allowed by law.

Please review the AdventHealth Joint Notice of Privacy Practices for more details about how your health information may be used and shared with others and how you may request restrictions.

Your personal identifying information is removed from the data elements that constitute the DNA analysis test results. By aggregating large numbers of de-identified DNA analysis data elements, scientists are able to better understand how certain genes may be associated with certain medical conditions.