Paper short abstract:

We consider how individuals and populations are (re)configured in the post-genomic era, with reference to the potential for stratified screening for cancer. The presentation will draw on existing literature and guidelines, and interviews with scientists engaged in research related to stratified screening.

Paper long abstract:

Cancer screening programmes are currently based on discrete risk factor(s) such as age or gender, and targeted at the level of the entire population. In the post-genomic era, there is potential to use genomic profiling in the development of stratified population-based screening, according to 'personal' assessments of risk. It is hoped this will improve the effectiveness of screening programmes, and reduce levels of unnecessary treatment. Here the identification of genetic variants associated with particular cancers is made with reference to aggregated genomic data, and used to develop individualised risk profiling. This configures new 'sub-populations' subject to targeted programmes of screening.

This presentation will draw on a review of literature on screening in the post-genomic era, and interviews with scientists engaged in research on stratified/personalised screening. The paper will explore how the objectives of public health are both challenged and reinforced by attempts to develop individual level risk profiles from population level genomics, as well as individual characteristics. Part of this will be the extension of patienthood into a period of 'pre-disease', the role of screening as a preventive and diagnostic tool, and the constructions of probable futures based on complex risk profiles. We consider how the population and the individual are constituted in scientific practice, and discuss tensions as scientific work moves between these two entities and towards the screening clinic. Beyond scientific practice, we will reflect on how the meaning of disease, and the experience of being a (pre-)patient, is becoming reconfigured in the post-genomic era.