by Wen Tu
Background
Healthcare has changed dramatically today and past with technology development (Moerenhout et al., 2018). The significant changes in healthcare help medical professionals to diagnose better and treat illnesses and diseases and improve people’s health and life quality. About 5% to 15% of breast cancer and colorectal cancer are inheritable and caused by genes (Moretz et al., 2022; Valencia et al., 2017). As one of the technological advances in healthcare, genetic testing provide valuable information in a variety of medical fields by examining your Deoxyribonucleic Acid (DNA) for alterations, also known as mutations or variants (Prevention, 2022), and it has become increasingly available and sophisticated recently (Striano & Minassian, 2020). As healthcare shifts towards a preventive paradigm from a curative paradigm, genetic testing is increasingly recognized as an effective means of preventing diseases, especially cancer, becoming more critical (Sandler et al., 2018).
Curative and preventive paradigm
The Curative paradigm is the traditional medical model that aims to cure or treat illnesses and diseases after they have already occurred through medications, surgeries, or other interventions (Fokunang et al., 2011), for example, chemotherapy, immunotherapy, stem cell transplant and surgery to treat cancer (Institute). The value of the curative paradigm is to provide immediate relief and can save lives in acute and severe cases. It plays a vital role in modern medicine, allowing patients to live longer and better and helping medical professionals to diagnose and treat a wide range of illnesses and injuries effectively.
The preventive paradigm is a healthcare model that aims to prevent illnesses and diseases from occurring in the first place. It promotes healthy behaviors and lifestyles, early detection, and screening (Organization, 2023). Genetic testing is an example of prevention. It helps people to identify the presence of inherited genetic conditions before any symptoms appear, assess the likelihood of a genetic condition being passed down to offspring, and provide insight into developing a cancer prevention or treatment plan (Prevention, 2022). Therefore, individuals may avoid costly and invasive medical treatments and procedures, and can save their lives by detecting and treating diseases in their early stages.
Driving forces leading to the shifts
The major reasons why prevention is increasingly important are the aging of the population, the increase in chronic diseases, and the increase in healthcare costs (Moerenhout et al., 2018). According to World Health Organization, the total life expectancy worldwide and the United States are 73 and 77 years old, respectively. In some countries, like Japan and Switzerland, people can live nearly 85 years (Organization, 2023). As the population ages, the incidence of chronic diseases, such as cancer, is increasing and creating a greater burden on individual and healthcare resources (Sun et al., 2020). As for the treatment, the curative paradigm always treats symptoms of cancer and neglects the root causes of diseases, while prevention helps to identify and manage cancer risk factors. For example, genetic testing can detect a patient's risk of developing cancer based on their genetic profile, potentially allowing for earlier intervention and better management of the condition before it progresses. As people live longer, it is beneficial to identify the risks of cancer or other diseases and have an earlier intervention to have a better life quality in older life. Prevention can also reduce people’s medical costs as patients can know and intervene in cancer and other diseases early.
Barriers to adopting the preventive paradigm
People have a better awareness of prevention, but there are still many barriers to adopting the preventive paradigm. Firstly, many people are unaware of the importance and benefits of preventive measures, especially those living in rural or low-income areas with less access to the internet and updated information, so they may ignore the health education or activities in the community or may not seek it out. Secondly, some preventive measures, like genetic testing, are too expensive and may cause anxiety. The expense associated with genetic testing can vary greatly, typically within the range of less than $100 to over $2,000 (Medicine, 2023). People may give it up since it is over the budget and make them worry about the health of themselves and family. Therefore, education on the long-term benefits of preventive care should be enhanced, especially in rural and low-income areas.
Status of preventive paradigm
As the curative paradigm is still prominent, the shift to the preventive paradigm is still underway. However, there are many developments in preventive measures. First is the public health initiative. Government and healthcare organizations have emphasized initiatives that aim to prevent illness and disease, including vaccination programs, health education campaigns, and community-based interventions (Kumar & Preetha, 2012). Also, the government has started to support research on genetic testing focusing on the prevention of physical and psychological health. As a guest speaker in NURS 7106-Context for Advancing Science course, Wendy Kohlmann unveiled a funded genetic counseling study in Utah that aims to share data and improve the health of a broader population (Kohlmann, 2023). Secondly, technological advances promote preventive interventions, such as genetic testing, wearables, and mobile health applications. Digital self-tracking apps help people take a more active role in their health and wellness as they know their medical information (Moerenhout et al., 2018).
Potential implications
The shift from a curative to a preventive paradigm can have significant implications in healthcare. Primary prevention actions are education on health risks, healthy diet, and immunization, and vaccination, and secondary prevention are genetic testing, early detection and evidence-based screening (Organization, 2023). Moreover, it promotes the development of integrative health. Instead of treating one organ system using conventional treatments like medication and physical rehabilitation, integrative health treats the whole person physically and psychologically, using both conventional and preventive care like genetic testing (Health, 2021).
Conclusion
With an aging population, increasing incidence of chronic diseases, and high financial costs, more emphasis has been put on prevention, although the curative paradigm is still dominant. As one of the technological advances contributing to this shift, genetic testing provides valuable information by examining DNA for mutations or variants, which helps prevent diseases like cancer. However, there are still barriers to adopting the preventive paradigm, such as a lack of awareness and high costs associated with genetic testing. Nevertheless, there are developments in preventive measures, including public health initiatives and government support for research in genetic testing.
Reference
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