Community genetics in the era of public health genomics.

Abstract

CG prefers to stay realistic and focus on what is technically possible already. Some regard CG as just another name for PHG or as just a small part of PHG [3, 4] . I hope to have convinced you that this cannot be the truth. Although CG and PHG have much in common, the differences cannot be ignored. Although hands and feet belong to the same body and have much in common, they cannot replace each other. Therefore, by wishing the new editors of Public Health Genomics all the best, the last word in this debate has not been said. PHG has been very productive in organizing support for their case so far. CG, however, has started recently to decrease the arrears by developing a new international multidisciplinary network. Those interested to become a member or to receive more information should send an e-mail to commgennet@gmail.com. Leo P. ten Kate, Amsterdam This eleventh volume (2008) of Community Genetics will be the last of this journal under its original name. It is also the final one after these 11 years I have the privilege to serve as editor-in-chief. From the twelfth volume (2009) onwards the journal will be continued under the new title Public Health Genomics , and I wish the new editors all the best. Notwithstanding community genetics or genomics (CG) and public health genetics or genomics (PHG) have much in common, there are important differences. As I have explained on several occasions the aim of PHG, to improve population health, is distinct from the goal of CG, to maximize benefits and minimize harm and discomfort from the application of medical genetics or genomics for as many individuals in the community as possible [1, 2] . One consequence of this difference is the ability of CG to deal with sensitive issues such as reproductive choices or presymptomatic testing for serious untreatable disorders, which cannot be justified by calling upon public health. The difference is also reflected in measures to assess the effectiveness of both: compliance and improvement of public health in PHG and empowerment of individuals with regard to informed decision making in CG. Other distinctions between CG and PHG relate to the size of the targeted population groups and the prevalence of the individual diseases in question. Public health is not improved convincingly by focussing on small communities and their particular problems, or by putting energy in dealing with rare diseases, while CG has no objection whatever to target these challenges. These distinctions have a parallel in the present overstretched expectations of PHG with regard to future applications of genetics and genomics in the combat of very common diseases, where