Integrating personalized genomics into Turkish healthcare system: A cancer-oriented pilot activity of Istanbul Northern Anatolian Public Hospitals with GLAB

Cancer is a major health problem worldwide. The annual number of newly diagnosed cancer cases has reached approximately 14 million people, according to the World Health Organization [1]. The incidence rates are growing, and the estimated annual number of cancer cases in the next 20 years is 22 million. According to the World Cancer Report, 8.2 million people died due to cancer in 2012, and the annual number of deaths is expected to increase to 13 million within 20 years [1, 2]. In Turkey, cancer is the second leading cause of death after cardiovascular diseases. Data from the Turkish Statistical Institute revealed that 79,628 people lost their life as result of cancer in 2013 [3]. The cancer incidence rate in Turkey is around 200 for every 100,000 people according to the Cancer Department of the Public Health Institution of Turkey, and Istanbul has the most cancer-related deaths with respect to entire population [4]. The most observed type of cancer in women is breast cancer, with an incidence rate of 40 cases for every 100,000 women. While the most diagnosed cancer types in men are respiratory system cancers, prostate, and colorectal cancers, with an incidence rate of 66, 26, and 21 cases, respectively, for every 100,000 males. There is inherited factor in 5% to 10% of breast and colorectal cancer cases [5]. When an accumulation of breast or colorectal cancer cases is observed in a family, the diagnosed patient should be screened for hereditary cancer gene mutations, and if the patient has a pathogenic mutation, family members who are at risk should also be screened. Cancer statistics of Turkey showed that only 47% of breast cancers and 29% of colorectal cancers have early diagnosis. In case of early diagnosis, the cure rate for breast and colorectal cancer is 90% and 80%, respectively