Next Generation DNA Sequencing Technologies and Implementation Science in Reducing the Impact of Familial Colorectal Cancers in Developing Countries

This paper describes our programme of ascertainment of familial colorectal cancers specifically Lynch syndrome and the application of implementation science. Patients are managed through a multidisciplinary team by providing genetic testing using next generation DNA sequencing technologies, genetic counselling, cascade screening, and surveillance colonoscopies. We describe the economic benefits of this kind of intervention, and emphasise the value of using this 'proven programme of precision medicine' to address the burden of inherited cancers in Africa. It is possible to reduce the incidence, survival, and health-economic impact of Lynch syndrome and other familial colorectal cancers through a combination of the following: (i) selected next-generation DNA sequencing technologies, (ii) targeted implementation science programs in cancer genetics, (iii) highly skilled multidisciplinary teams of medical scientists, oncologists, and clinical specialists, and (iv) patients and their families as the key stakeholders.