Canada: Public Health Genomics

Abstract

Canada has a diverse population of 32 million people and a universal, publicly funded health care system provided through provincial and territorial health insurance plans. Public health activities are resourced at provincial/territorial level with strategic coordination from national bodies. Canada has one of the longest-standing genetics professional specialty organizations and is one of the few countries offering master’s level training designed specifically for genetic counselors. Prenatal screening is offered as part of routine clinical prenatal services with variable uptake. Surveillance of the effect of prenatal screening and diagnosis on the birth prevalence of congenital anomalies is limited by gaps and variations in surveillance systems. Newborn screening programs vary between provinces and territories in terms of organization and conditions screened for. The last decade has witnessed a four-fold increase in requests for genetic testing, especially for late onset diseases. Tests are performed in provincial laboratories or outside Canada. There is wide variation in participation in laboratory quality assurance schemes, and there are few regulatory frameworks in Canada that are directly relevant to genetics testing services or population genetics. Health technology assessment in Canada is conducted by a diverse range of organizations, several of which have produced reports related to genetics. Several large-scale population cohort studies are underway or planned, with initiatives to harmonize their conduct and the management of ethical issues, both within Canada and with similar projects in other countries.

Genetics in Health Care: An Overview of Current and Emerging Models

“…Canada recognised genetics as a medical speciality in 1986 [56]. Canada was among the first countries worldwide to develop standards of training and expertise, overseen by a newly minted Canadian College of Medical Genetics in 1976 [57].…”

“…Four accredited genetic counselling programs were available at the master’s level (2 in Quebec, 1 in Ontario and 1 in British Columbia), 3 of which were also accredited by the American Board of Genetic Counseling [58,59]. By 2009, the Canadian Association of Genetic Counsellors had certified 250 genetic counsellors [56]. …”

CE: Knowledge of Precision Medicine and Health Care: An Essential Nursing Competency

“…A significant body of literature, however, highlights several factors that contribute to the limited genetics education of health care professionals and the poor integration of genetics into health care. 32,33,34,35,36,37,38,39,40,41,42,43,44,45,46 These factors include crowded curricula; lack of knowledgeable faculty; genetics content that is not presented in a way that leads to long-term knowledge retention; failure to incorporate genetics into clinical training; inadequate representation of genetics on certifying exams; lack of evidence-based guidelines in genetics; and misconceptions that genetic medicine is defined by rare, Mendelian disorders, when in fact genetics is increasingly concerned with the common, chronic diseases that are the daily focus for most health professionals.…”

Integrating Personalized Medicine in the Canadian Environment: Efforts Facilitating Oncology Clinical Research

“…Saguenay-Lac Saint-Jean, Newfoundland) or specific ancestral backgrounds (e.g. Hutterites, First Nations people) [1,2,3]. …”