How to structure an oncogenetics service for the public health system: Report of the implementation of the first service in Northeastern Brazil
Identifying carriers of genetic mutations that increase the risk of developing cancer allows to adopt timely risk-reducing strategies. However, due to the elevated cost of genetic testing, few oncogenetics services are available in the Brazilian public health care system, especially in economically...
Saved in:
| Published in: | Cancer genetics Vol. 250-251; pp. 6 - 11 |
|---|---|
| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Elsevier Inc
01-01-2021
|
| Subjects: | |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | Identifying carriers of genetic mutations that increase the risk of developing cancer allows to adopt timely risk-reducing strategies. However, due to the elevated cost of genetic testing, few oncogenetics services are available in the Brazilian public health care system, especially in economically disadvantaged areas.
To describe the implementation of an oncogenetics service for patients suspected of hereditary cancer syndromes (HBOC and HNPCC) at a philanthropic referral oncology hospital in Northeastern Brazil, funded by the Ministry of Health's National Oncology Care Support Program (PRONON).
The service was implemented with the PDCA method (Plan, Do, Check and Act).
During the first year of operation (starting in August 2018), 675 individuals were examined, of whom 272 patients and 98 family members were submitted to genetic testing. This included the collection of 338 DNA samples of which 300 were sequenced. The analysis identified 48 (17.1%) mutations for HBOC and 19 (6.8%) for HNPCC.
In one year, the oncogenetics service was able to benefit over 300 families by generating advanced molecular data which may be used for tailoring cancer prevention and management. |
|---|---|
| AbstractList | Identifying carriers of genetic mutations that increase the risk of developing cancer allows to adopt timely risk-reducing strategies. However, due to the elevated cost of genetic testing, few oncogenetics services are available in the Brazilian public health care system, especially in economically disadvantaged areas.
To describe the implementation of an oncogenetics service for patients suspected of hereditary cancer syndromes (HBOC and HNPCC) at a philanthropic referral oncology hospital in Northeastern Brazil, funded by the Ministry of Health's National Oncology Care Support Program (PRONON).
The service was implemented with the PDCA method (Plan, Do, Check and Act).
During the first year of operation (starting in August 2018), 675 individuals were examined, of whom 272 patients and 98 family members were submitted to genetic testing. This included the collection of 338 DNA samples of which 300 were sequenced. The analysis identified 48 (17.1%) mutations for HBOC and 19 (6.8%) for HNPCC.
In one year, the oncogenetics service was able to benefit over 300 families by generating advanced molecular data which may be used for tailoring cancer prevention and management. |
| Author | Lima, Marcos Venício Alves Nogueira, Camila Sampaio de Albuquerque, Clarissa Gondim Picanço Wong, Deysi Viviana Tenazoa Silva-Fernandes, Isabelle Joyce de Lima Oliveira, Francisca Fernanda Barbosa Silva, Paulo Goberlânio de Barros Bitencourt, Flávio da Silveira |
| Author_xml | – sequence: 1 givenname: Camila Sampaio orcidid: 0000-0002-2888-2039 surname: Nogueira fullname: Nogueira, Camila Sampaio organization: Federal University of Ceará, Rua Alexandre Baraúna 994, Rodolfo Teófilo, Fortaleza, Ceará, Brazil – sequence: 2 givenname: Isabelle Joyce de Lima surname: Silva-Fernandes fullname: Silva-Fernandes, Isabelle Joyce de Lima email: isabellejoyce@gmail.com organization: Ceará Cancer Institute, Rua Papi Junior 1222, Rodolfo Teófilo, Fortaleza, Ceará, Brazil – sequence: 3 givenname: Clarissa Gondim Picanço surname: de Albuquerque fullname: de Albuquerque, Clarissa Gondim Picanço organization: Ceará Cancer Institute, Rua Papi Junior 1222, Rodolfo Teófilo, Fortaleza, Ceará, Brazil – sequence: 4 givenname: Francisca Fernanda Barbosa surname: Oliveira fullname: Oliveira, Francisca Fernanda Barbosa organization: Ceará Cancer Institute, Rua Papi Junior 1222, Rodolfo Teófilo, Fortaleza, Ceará, Brazil – sequence: 5 givenname: Deysi Viviana Tenazoa orcidid: 0000-0002-9741-7560 surname: Wong fullname: Wong, Deysi Viviana Tenazoa organization: Ceará Cancer Institute, Rua Papi Junior 1222, Rodolfo Teófilo, Fortaleza, Ceará, Brazil – sequence: 6 givenname: Paulo Goberlânio de Barros surname: Silva fullname: Silva, Paulo Goberlânio de Barros organization: Ceará Cancer Institute, Rua Papi Junior 1222, Rodolfo Teófilo, Fortaleza, Ceará, Brazil – sequence: 7 givenname: Flávio da Silveira orcidid: 0000-0001-8985-4579 surname: Bitencourt fullname: Bitencourt, Flávio da Silveira organization: Ceará Cancer Institute, Rua Papi Junior 1222, Rodolfo Teófilo, Fortaleza, Ceará, Brazil – sequence: 8 givenname: Marcos Venício Alves surname: Lima fullname: Lima, Marcos Venício Alves organization: Ceará Cancer Institute, Rua Papi Junior 1222, Rodolfo Teófilo, Fortaleza, Ceará, Brazil |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33212392$$D View this record in MEDLINE/PubMed |
| BookMark | eNqFkN1OAyEQRonRWK2-gvICrQNbl13v1PiXNJoYvSa7MFiaXWiAaupL-MpSq72VG8jk-86Qc0h2nXdIyCmDMQNWns3HqnEKwxu6MQeep2wMwHfIAecMRkII2N2-Sz4gxzHOIZ_JOVSi2CeDouCMFzU_IF_3_oMmT2MKS5WWAWnjqHfKZzgmqyKNGN6tQmp8oGmGdLFsO6voDJsuzWhcxYT9BX3GhQ-JevOTsf2iwx5dapL17m9qbIhpy7OOPuZK5mRCcPQqNJ-2OyJ7pukiHv_eQ_J6e_NyfT-aPt09XF9OR6oQLI3KCkWFqqyZERODYBiYuoRSQwFMaajryiglqnLSgmprpivdtoyZ5rzVum7bYkjEhquCjzGgkYtg-yasJAO5tizncmtZri1LxmS2nJsnm2YW0aPe9v6c5sDlJoD5_-8Wg4zKYkZpG1Alqb39d8k3YJiXvA |
| CitedBy_id | crossref_primary_10_1155_2022_5235349 crossref_primary_10_12998_wjcc_v12_i19_3734 |
| Cites_doi | 10.1038/nrm2858 10.9771/cmbio.v9i3.5167 10.1093/jnci/djt095 10.1186/1471-2407-12-64 10.1590/1980-549720180012 10.1007/s10689-013-9616-0 10.6004/jnccn.2010.0044 10.1186/s12885-019-5463-1 10.3322/caac.21551 10.1590/0102-311x00030713 |
| ContentType | Journal Article |
| Copyright | 2020 Copyright © 2020. Published by Elsevier Inc. |
| Copyright_xml | – notice: 2020 – notice: Copyright © 2020. Published by Elsevier Inc. |
| DBID | NPM AAYXX CITATION |
| DOI | 10.1016/j.cancergen.2020.11.002 |
| DatabaseName | PubMed CrossRef |
| DatabaseTitle | PubMed CrossRef |
| DatabaseTitleList | PubMed |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 2210-7770 |
| EndPage | 11 |
| ExternalDocumentID | 10_1016_j_cancergen_2020_11_002 33212392 S2210776220302805 |
| Genre | Journal Article |
| GroupedDBID | --- --K --M .1- .FO .~1 0R~ 1P~ 1~. 4.4 457 53G 5VS 8P~ AABNK AACTN AAEDT AAEDW AAIAV AAIKJ AAKOC AALRI AAOAW AAQFI AAXUO ABBQC ABGSF ABJNI ABLVK ABMAC ABMZM ABUDA ABXDB ABYKQ ACDAQ ACGFS ACIUM ACRLP ADBBV ADEZE ADMUD ADUVX AEBSH AEHWI AEKER AENEX AEVXI AFKWA AFRHN AFTJW AFXIZ AGHFR AGUBO AGYEJ AIEXJ AIKHN AITUG AJBFU AJOXV AJRQY AJUYK ALMA_UNASSIGNED_HOLDINGS AMFUW AMRAJ ANZVX AXJTR BKOJK BLXMC BNPGV DOVZS EBS EFJIC EFLBG EJD F5P FDB FEDTE FIRID FNPLU FYGXN GBLVA HVGLF HZ~ J1W KOM LCYCR M41 MO0 O-L O9- OAUVE OC~ OO- P-8 P-9 PC. Q38 RIG ROL SCC SDF SEL SES SPCBC SSH SSU SSZ T5K Z5R ~G- AAXKI AFJKZ AKRWK NPM AAYXX CITATION |
| ID | FETCH-LOGICAL-c371t-68e78ec691f74fe0f10f9606d0301cd0998fcc7864b0cb91d8dbb11fa5bdd9bb3 |
| ISSN | 2210-7762 |
| IngestDate | Thu Sep 26 17:36:29 EDT 2024 Sat Sep 28 08:30:15 EDT 2024 Fri Feb 23 02:46:36 EST 2024 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Keywords | Breast neoplasms Colorectal neoplasms Mutagenicity testing Ovarian neoplasms Lynch syndrome |
| Language | English |
| License | Copyright © 2020. Published by Elsevier Inc. |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-c371t-68e78ec691f74fe0f10f9606d0301cd0998fcc7864b0cb91d8dbb11fa5bdd9bb3 |
| ORCID | 0000-0002-9741-7560 0000-0001-8985-4579 0000-0002-2888-2039 |
| PMID | 33212392 |
| PageCount | 6 |
| ParticipantIDs | crossref_primary_10_1016_j_cancergen_2020_11_002 pubmed_primary_33212392 elsevier_sciencedirect_doi_10_1016_j_cancergen_2020_11_002 |
| PublicationCentury | 2000 |
| PublicationDate | January 2021 2021-Jan 2021-01-00 |
| PublicationDateYYYYMMDD | 2021-01-01 |
| PublicationDate_xml | – month: 01 year: 2021 text: January 2021 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Cancer genetics |
| PublicationTitleAlternate | Cancer Genet |
| PublicationYear | 2021 |
| Publisher | Elsevier Inc |
| Publisher_xml | – name: Elsevier Inc |
| References | Mavaddat, Peock, Frost, Ellis, Platte, Fineberg (bib0009) 2013; 105 Negrini, Gorgoulis, Halazonetis (bib0007) 2010; 11 World Health Organization (WHO), 2018. Câncer. Folha informativa. Available at Lajus (bib0014) 2010; 9 Accessed on 10 Dec 2019. Accessed on 29 Oct 2019. Plazzer, Sijmons, Woods, Peltomaki, Thompson, Dendunnen (bib0012) 2013; 12 Instituto Nacional do Câncer (INCA), 2019. Conceito e magnitude do câncer de mama. Available at Accessed on 31 Oct 2019. Leonel P.H. Aplicação Prática da Técnica do PDCA e das Ferramentas da Qualidade no Gerenciamento de Processos Industriais para Melhoria e Manutenção de Resultados. Monografia - Universidade Federal de Juiz de Fora, Departamento de Engenharia de Produção. (EPD/UFJF, Graduação, Engenharia de Produção, 2008) Minas Gerais, 2008. Available at Instituto Nacional do Câncer (INCA), 2018. Estimativa 2018-Incidência de câncer no Brasil. [S.1:s.n.], 2017. 130 p. Available at Global Cancer Observatory (GLOBOCAN), 2018. Available at Achatz M.I.W. A oncogenética e o desafio da identificação das famílias de alto risco. Revista Onco. Ano Nov/Dez, 2012;13(14). ISSN 2179-0930. Barbosa, Costa, Pérez, Souza (bib0015) 2015; 1 Oliveira, Latorre, Tanaka, Rossi, Curado (bib0016) 2018; 21 Accessed on 1 Nov 2019. Hampel (bib0010) 2010; 8 Siegel, Miller, Jemal (bib0005) 2019; 69 Accessed on 24 Dec 2019. Abdulrashid, Alhussaini, Ahmed, Thalib (bib0006) 2019; 19 Maher, Hodgson (bib0008) 1999 Santos, Valentim, Carneiro, Oliveira, Ferreira, Aguiar Jr (bib0011) 2012; 12 Santos, Melo, Koifman, Koifman (bib0018) 2013; 29 Pacheco A.P.R., Salles B.W., Garcia M.A., Possamal O. O ciclo pdca na gestão do conhecimento: uma abordagem sistêmica. Universidade federal de santa catarina - Departamento de Engenharia de Produção e Sistemas. 2005. Available at 10.1016/j.cancergen.2020.11.002_bib0001 10.1016/j.cancergen.2020.11.002_bib0003 Lajus (10.1016/j.cancergen.2020.11.002_bib0014) 2010; 9 10.1016/j.cancergen.2020.11.002_bib0002 10.1016/j.cancergen.2020.11.002_bib0013 Negrini (10.1016/j.cancergen.2020.11.002_bib0007) 2010; 11 10.1016/j.cancergen.2020.11.002_bib0019 10.1016/j.cancergen.2020.11.002_bib0004 Plazzer (10.1016/j.cancergen.2020.11.002_bib0012) 2013; 12 Maher (10.1016/j.cancergen.2020.11.002_bib0008) 1999 Santos (10.1016/j.cancergen.2020.11.002_bib0018) 2013; 29 Barbosa (10.1016/j.cancergen.2020.11.002_bib0015) 2015; 1 10.1016/j.cancergen.2020.11.002_bib0017 Santos (10.1016/j.cancergen.2020.11.002_bib0011) 2012; 12 Hampel (10.1016/j.cancergen.2020.11.002_bib0010) 2010; 8 Siegel (10.1016/j.cancergen.2020.11.002_bib0005) 2019; 69 Abdulrashid (10.1016/j.cancergen.2020.11.002_bib0006) 2019; 19 Mavaddat (10.1016/j.cancergen.2020.11.002_bib0009) 2013; 105 Oliveira (10.1016/j.cancergen.2020.11.002_bib0016) 2018; 21 |
| References_xml | – volume: 8 start-page: 597 year: 2010 end-page: 601 ident: bib0010 article-title: Point: justification for Lynch syndrome screening among all patients with newly diagnosed colorectal cancer publication-title: J Natl Compr Canc Netw contributor: fullname: Hampel – volume: 12 start-page: 175 year: 2013 end-page: 180 ident: bib0012 article-title: The InSiGHT database: utilizing 100 years of insights into Lynch Syndrome publication-title: Fam Cancer contributor: fullname: Dendunnen – volume: 29 start-page: 2230 year: 2013 end-page: 2240 ident: bib0018 article-title: Breast cancer incidence and mortality in women under 50 years of age in Brazil publication-title: Cad Saude Publica contributor: fullname: Koifman – volume: 19 start-page: 256 year: 2019 ident: bib0006 article-title: Prevalence of BRCA mutations among hereditary breast and/or ovarian cancer patients in Arab countries: systematic review and meta-analysis publication-title: BMC Cancer contributor: fullname: Thalib – volume: 11 start-page: 220 year: 2010 end-page: 228 ident: bib0007 article-title: Genomic instability–an evolving hallmark of cancer publication-title: Nat Rev Mol Cell Biol contributor: fullname: Halazonetis – volume: 12 start-page: 64 year: 2012 ident: bib0011 article-title: Predictive models for mutations in mismatch repair genes: implication for genetic counseling in developing countries publication-title: BMC Cancer contributor: fullname: Aguiar Jr – year: 1999 ident: bib0008 article-title: A practical guide to human cancer genetics by shirley V. hodgson contributor: fullname: Hodgson – volume: 69 start-page: 7 year: 2019 end-page: 34 ident: bib0005 article-title: Cancer statistics publication-title: CA Cancer J Clin contributor: fullname: Jemal – volume: 9 start-page: 252 year: 2010 end-page: 256 ident: bib0014 article-title: A utilização de inibidores de PARP na profilaxia e no tratamento do câncer de mama deficiente no gene BRCA1 publication-title: Revista de Ciências Médicas e Biológicas contributor: fullname: Lajus – volume: 105 start-page: 812 year: 2013 end-page: 822 ident: bib0009 article-title: Cancer risks for BRCA1 and BRCA2 mutation carriers: results from prospective analysis of EMBRACE publication-title: J Natl Cancer Inst. contributor: fullname: Fineberg – volume: 21 year: 2018 ident: bib0016 article-title: Disparidade na mortalidade de câncer colorretal nos estados brasileiros publication-title: Rev Bras Epidemiol contributor: fullname: Curado – volume: 1 start-page: 4 year: 2015 end-page: 14 ident: bib0015 article-title: Mortalidade por câncer de mama nos estados do nordeste do Brasil: tendências atuais e projeções de 2030 publication-title: Rev Ciência Plural contributor: fullname: Souza – ident: 10.1016/j.cancergen.2020.11.002_bib0004 – volume: 1 start-page: 4 issue: 1 year: 2015 ident: 10.1016/j.cancergen.2020.11.002_bib0015 article-title: Mortalidade por câncer de mama nos estados do nordeste do Brasil: tendências atuais e projeções de 2030 publication-title: Rev Ciência Plural contributor: fullname: Barbosa – volume: 11 start-page: 220 issue: 3 year: 2010 ident: 10.1016/j.cancergen.2020.11.002_bib0007 article-title: Genomic instability–an evolving hallmark of cancer publication-title: Nat Rev Mol Cell Biol doi: 10.1038/nrm2858 contributor: fullname: Negrini – ident: 10.1016/j.cancergen.2020.11.002_bib0002 – ident: 10.1016/j.cancergen.2020.11.002_bib0003 – volume: 9 start-page: 252 issue: 3 year: 2010 ident: 10.1016/j.cancergen.2020.11.002_bib0014 article-title: A utilização de inibidores de PARP na profilaxia e no tratamento do câncer de mama deficiente no gene BRCA1 publication-title: Revista de Ciências Médicas e Biológicas doi: 10.9771/cmbio.v9i3.5167 contributor: fullname: Lajus – volume: 105 start-page: 812 issue: 11 year: 2013 ident: 10.1016/j.cancergen.2020.11.002_bib0009 article-title: Cancer risks for BRCA1 and BRCA2 mutation carriers: results from prospective analysis of EMBRACE publication-title: J Natl Cancer Inst. doi: 10.1093/jnci/djt095 contributor: fullname: Mavaddat – year: 1999 ident: 10.1016/j.cancergen.2020.11.002_bib0008 contributor: fullname: Maher – volume: 12 start-page: 64 year: 2012 ident: 10.1016/j.cancergen.2020.11.002_bib0011 article-title: Predictive models for mutations in mismatch repair genes: implication for genetic counseling in developing countries publication-title: BMC Cancer doi: 10.1186/1471-2407-12-64 contributor: fullname: Santos – volume: 21 year: 2018 ident: 10.1016/j.cancergen.2020.11.002_bib0016 article-title: Disparidade na mortalidade de câncer colorretal nos estados brasileiros publication-title: Rev Bras Epidemiol doi: 10.1590/1980-549720180012 contributor: fullname: Oliveira – ident: 10.1016/j.cancergen.2020.11.002_bib0013 – volume: 12 start-page: 175 year: 2013 ident: 10.1016/j.cancergen.2020.11.002_bib0012 article-title: The InSiGHT database: utilizing 100 years of insights into Lynch Syndrome publication-title: Fam Cancer doi: 10.1007/s10689-013-9616-0 contributor: fullname: Plazzer – ident: 10.1016/j.cancergen.2020.11.002_bib0017 – volume: 8 start-page: 597 issue: 5 year: 2010 ident: 10.1016/j.cancergen.2020.11.002_bib0010 article-title: Point: justification for Lynch syndrome screening among all patients with newly diagnosed colorectal cancer publication-title: J Natl Compr Canc Netw doi: 10.6004/jnccn.2010.0044 contributor: fullname: Hampel – ident: 10.1016/j.cancergen.2020.11.002_bib0019 – volume: 19 start-page: 256 issue: 1 year: 2019 ident: 10.1016/j.cancergen.2020.11.002_bib0006 article-title: Prevalence of BRCA mutations among hereditary breast and/or ovarian cancer patients in Arab countries: systematic review and meta-analysis publication-title: BMC Cancer doi: 10.1186/s12885-019-5463-1 contributor: fullname: Abdulrashid – volume: 69 start-page: 7 year: 2019 ident: 10.1016/j.cancergen.2020.11.002_bib0005 article-title: Cancer statistics publication-title: CA Cancer J Clin doi: 10.3322/caac.21551 contributor: fullname: Siegel – ident: 10.1016/j.cancergen.2020.11.002_bib0001 – volume: 29 start-page: 2230 issue: 11 year: 2013 ident: 10.1016/j.cancergen.2020.11.002_bib0018 article-title: Breast cancer incidence and mortality in women under 50 years of age in Brazil publication-title: Cad Saude Publica doi: 10.1590/0102-311x00030713 contributor: fullname: Santos |
| SSID | ssj0000450873 |
| Score | 2.2646384 |
| Snippet | Identifying carriers of genetic mutations that increase the risk of developing cancer allows to adopt timely risk-reducing strategies. However, due to the... |
| SourceID | crossref pubmed elsevier |
| SourceType | Aggregation Database Index Database Publisher |
| StartPage | 6 |
| SubjectTerms | Breast neoplasms Colorectal neoplasms Lynch syndrome Mutagenicity testing Ovarian neoplasms |
| Title | How to structure an oncogenetics service for the public health system: Report of the implementation of the first service in Northeastern Brazil |
| URI | https://dx.doi.org/10.1016/j.cancergen.2020.11.002 https://www.ncbi.nlm.nih.gov/pubmed/33212392 |
| Volume | 250-251 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://sdu.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV1Lb9QwELbaIiEuiDflJR-4RakSJ1knvUFZ6IWH2CIhLpHjh0i1TdBuQYI_wV9mxq_NAlJBiMNGG2tjW5lvZ8bjzzOEPOZSNYzzJq26QqRlboq0MWWXYvaxWkvFlM3Tfbzgr97Xz-blfGc3lL7btP1XSUMbyBpPzv6FtGOn0ADfQeZwBanD9Y_kbmvEjYnLC-t2B5JxkCM8oG1K5rXTDpFfOE10_dFndnY0OXTNA4egPwtE8-BiYqvpwXmMPfaD2wbCckBYYO3pSnzzDI5NLgSpV0mYS4xEY_yotxWPkiOMuIhkgYkgHUfMBoD65ReRhqC302xrgZsmeLLtq8TTX3hYKxoZuMXdB7B6K_jYjpdYb3EtkhfjoPqz5A0aAMsT4HGY10tQ_n4ivuSIFIkfVtjNmXEtppESlv8UKYlHeLYYpgzWvLDE8CZBT9tcRZNgJsBXTJlPjuuU_WziNTiL8Ys9cqGR0wNpXy-83QOYGNopDORtTHAkRi5waJwNA-XLakzOe4mBCkUN_qF6G6OH4IhntaVPxPlvkRd_O94FrtfErzq5Rq76BRF94pB8nezo4Qa5_NJTPm6S7wBoej7SCGgqBjoFNPXwowBoCuCjDtDUAZo6QB9SB2c6GvubbTiHVgvn2F8_0CmcqYPzLfLu-fzk6Dj1VURSWfD8PJ3VmoPWmTW54aXRmckzg8t2hcEAqWCFVBspeT0ru0x2Ta5q1XV5bkTVKdV0XXGb7A3joO8SmneMSW2gK1aVzMiG16U25QzsZFUrzvZJFl5w-8kli2kDi_K0jTJpUSaw9G5BJvvkMAii9T6v82VbgNDFD99xooujFQW6og279y_d3idXNn-fB2QP5Ksfkt21-vzIovAHJo3g7w |
| link.rule.ids | 315,782,786,27933,27934 |
| linkProvider | Elsevier |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=How+to+structure+an+oncogenetics+service+for+the+public+health+system%3A+Report+of+the+implementation+of+the+first+service+in+Northeastern+Brazil&rft.jtitle=Cancer+genetics&rft.au=Nogueira%2C+Camila+Sampaio&rft.au=Silva-Fernandes%2C+Isabelle+Joyce+de+Lima&rft.au=de+Albuquerque%2C+Clarissa+Gondim+Pican%C3%A7o&rft.au=Oliveira%2C+Francisca+Fernanda+Barbosa&rft.date=2021-01-01&rft.pub=Elsevier+Inc&rft.issn=2210-7762&rft.eissn=2210-7770&rft.volume=250-251&rft.spage=6&rft.epage=11&rft_id=info:doi/10.1016%2Fj.cancergen.2020.11.002&rft.externalDocID=S2210776220302805 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2210-7762&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2210-7762&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2210-7762&client=summon |