Familial Cancer

, Volume 9, Issue 1, pp 9–14 | Cite as

A clinical perspective on ethical arguments around prenatal diagnosis and preimplantation genetic diagnosis for later onset inherited cancer predispositions

  • Tara Clancy


Prenatal diagnosis (PND) and preimplantation genetic diagnosis (PGD) for later onset and/or reduced penetrance inherited cancer predispositions, e.g. familial adenomatous polyposis, hereditary non-polyposis colorectal cancer/Lynch syndrome and hereditary breast and ovarian cancer, raise a number of ethical issues. Some of these are the same as for conditions which present early in childhood, are fully penetrant and for which no/limited treatment options are possible; others relate to whether reduced penetrance and/or the availability of treatment mean that these are not serious (enough) conditions to warrant tests prior to/during pregnancy or to justify termination of pregnancy. However, attempts to reach a consensus on what counts as a serious (enough) condition in the context of PND and PGD have been unsuccessful. Such a definition may anyway be unhelpful if it cannot also take into account, for example, the woman’s/couple’s awareness and experience of the condition and the impact of the condition on affected individuals and their families. Individuals affected by, or at high risk of, later onset and/or reduced penetrance inherited cancer predispositions are generally supportive of access to PND and PGD for their own conditions, even if they would not consider using it themselves. Professionals working in clinical cancer genetics need to be prepared to discuss PND and PGD with this group of patients.


BRCA1/2 Cancer predispositions Ethical issues FAP HNPCC Preimplantation genetic diagnosis Prenatal diagnosis 



European Society of Human Reproduction and Embryology


Familial adenomatous polyposis


Hereditary non-polyposis colorectal cancer


Human Fertilisation and Embryology Authority


Preimplantation genetic diagnosis


Prenatal diagnosis



Thank you to Lauren Kerzin-Storrar, Anneke Lucassen and Rhona MacLeod and the reviewers for their helpful comments on the previous draft of this paper. Tara Clancy is supported by the Manchester Academic Health Sciences Centre and the NIHR Manchester Biomedical Research Centre.


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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  1. 1.Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation TrustSt Mary’s HospitalManchesterUK

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