Implementation of Genetic Counseling and Germline Multigene Testing for Hereditary Cancer in Cameroon: Insights from the GENCAF Pilot Program
- 1 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 2 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 3 National Cancer Control Committee, Yaounde, Cameroon
- 4 Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Nigeria
- 5 Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
- 6 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 7 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 8 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 9 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 10 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 11 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 12 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 13 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 14 Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
- 15 Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- 16 Department of Medicine, Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
- 17 Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- 18 Yaounde Central Hospital, Yaounde, Cameroon
Abstract
Introduction: Sub-Saharan Africa faces a rapidly growing cancer burden, yet genetic counseling and hereditary cancer testing remain absent in most national health systems. In Cameroon, no structured oncogenetics services existed prior to 2020, despite the frequent clinical observation of early-onset cancers and strong familial clustering. This project aimed to implement and evaluate the operational outcomes of the first structured genetic counseling and multigene testing program for hereditary cancer in Cameroon. Methods: The Genetic Cancer Families (GENCAF) initiative was established as a collaborative North-South (University of Chicago, City of Hope) and South-South (University of Ibadan) program across three oncology centers in Yaounde. Following capacity building and a feasibility study whose results are published separately, the program proceeded to pilot germline testing using next-generation sequencing (NGS) for 29 cancer susceptibility genes in 94 patients. Results: The program trained Cameroon’s first two certified cancer genetic counselors and 19 supporting health professionals. The feasibility and acceptability outcomes (including knowledge-score improvement from 41% to 78%, p Conclusion: GENCAF demonstrates the feasibility and high acceptability of introducing oncogenetics in Cameroon. The high diagnostic yield (27.7%) confirms a substantial burden of hereditary cancer, necessitating the integration of genetic services into national cancer control plans.
- Morhason-Bello, I.O., Odedina, F., Rebbeck, T.R., Harford, J., Dangou, J., Denny, L., et al . (2013) Challenges and Opportunities in Cancer Control in Africa: A Perspective from the African Organisation for Research and Training in Cancer. The Lancet Oncology , 14, e142-e151. https://doi.org/10.1016/s1470-2045(12)70482-5
- Fackenthal, J.D. and Olopade, O.I. (2007) Breast Cancer Risk Associated with BRCA1 and BRCA2 in Diverse Populations. Nature Reviews Cancer , 7, 937-948. https://doi.org/10.1038/nrc2054
- Adedokun, B., Zheng, Y., Ndom, P., Gakwaya, A., Makumbi, T., Zhou, A.Y., et al . (2020) Prevalence of Inherited Mutations in Breast Cancer Predisposition Genes among Women in Uganda and Cameroon. Cancer Epidemiology , Biomarkers & Prevention , 29, 359-367. https://doi.org/10.1158/1055-9965.epi-19-0506
- Hayat, M., Chen, W.C., Brandenburg, J., Babb de Villiers, C., Ramsay, M. and Mathew, C.G. (2021) Genetic Susceptibility to Breast Cancer in Sub-Saharan African Populations. JCO Global Oncology , 7, 1462-1471. https://doi.org/10.1200/go.21.00089
- Rotimi, S.O., Rotimi, O.A. and Salhia, B. (2021) A Review of Cancer Genetics and Genomics Studies in Africa. Frontiers in Oncology , 10, Article 606400. https://doi.org/10.3389/fonc.2020.606400
- Bentley, A.R., Callier, S.L. and Rotimi, C.N. (2020) Evaluating the Promise of Inclusion of African Ancestry Populations in Genomics. npj Genomic Medicine , 5, Article No. 5. https://doi.org/10.1038/s41525-019-0111-x
- Ginsburg, O. and Narod, S.A. (2018) Clinical Cancer Genetics in a Lower-Middle Income Country: Considerations for Policymaking. JCO Global Oncology , 4, JGO.18.00081.
- Rotimi, C.N., Bentley, A.R., Doumatey, A.P., Chen, G., Shriner, D. and Adeyemo, A. (2017) The Genomic Landscape of African Populations in Health and Disease. Human Molecular Genetics , 26, R225-R236. https://doi.org/10.1093/hmg/ddx253
- Fatumo, S., Chikowore, T., Choudhury, A., Ayub, M., Martin, A.R. and Kuchenbaecker, K. (2022) A Roadmap to Increase Diversity in Genomic Studies. Nature Medicine , 28, 243-250. https://doi.org/10.1038/s41591-021-01672-4
- Popejoy, A.B. and Fullerton, S.M. (2016) Genomics Is Failing on Diversity. Nature , 538, 161-164. https://doi.org/10.1038/538161a
- Esson Mapoko, B.S., Chi Ndi, K., Tabola, L., Mouaye, V., Douanla, P., Nsangou, N., et al . (2023) Feasibility of Cancer Genetic Counselling and Screening in Cameroon: Perceived Benefits and Barriers. eCancerMedicalScience , 17, Article 1588. https://doi.org/10.3332/ecancer.2023.1588