Problems of Social Hygiene, Public Health and History of MedicineProblems of Social Hygiene, Public Health and History of Medicine0869-866X2412-2106Joint-Stock Company Chicot278210.32687/0869-866X-2026-34-4-911-916Original ArticleIMPLEMENTATION OF A DYNAMIC SURVEILLANCE PROGRAM FOR EARLY CANCER DETECTION IN HEALTHY INDIVIDUALS CARRYING PATHOGENIC VARIANTSBodunovaN. A.NaigovzinaN. B.KhatkovI. E.MineevaD. T.PatrushevM. A.BilyalovA. I.DanishevichA. M.A. S. Loginov Moscow Clinical Scientific and Practical Center of the Moscow City Health Department, Moscow, Russian Federation, 111123Russian University of Medicine, Moscow, Russian Federation, 127006HSE University, Moscow, Russian Federation, 101000LIFT — Research Center for Fundamental and Applied Biomedical Studies, Moscow, Russian Federation, 1212053108202634491191601092026Copyright © 2026,2026The aim of the study was to develop and evaluate a multidisciplinary clinical routing model for healthy carriers of pathogenic germline variants for early cancer detection. An organizational study was conducted involving the creation of a registry of pathogenic variant carriers and implementation of a surveillance program including genetic counseling, specialist consultations, and instrumental screening. The registry included 986 carriers of pathogenic variants, including 551 clinically healthy individuals. During follow-up, 57 malignancies were detected, predominantly breast cancer; all cases were diagnosed at stages I—II. The study demonstrated that the clinical value of genetic testing is realized only within an organized system of patient routing and dynamic surveillance. The proposed model may serve as an organizational prototype for monitoring individuals at high hereditary cancer risk.BRCA1BRCA2hereditary cancer syndromes, BRCA1, BRCA2, genetic testing, patient routing, surveillance, early diagnosis, multidisciplinary approach.наследственные опухолевые синдромыгенетическое тестированиемаршрутизация пациентовдиспансерное наблюдениеранняя диагностикамеждисциплинарный подход.1.Cerretelli G, Ager A, Arends MJ, Frayling IM. Molecular pathology of Lynch syndrome. J Pathol. 2020;250(5):518—31. Doi: 10.1002/path.54222.Daly MB, Pal T, Maxwell KN, Churpek J, Kohlmann W, AlHilli Z, и др. NCCN Guidelines® Insights: Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 2.2024. J Natl Compr Cancer Netw JNCCN. 2023;21(10):1000—10. Doi: 10.6004/jnccn.2023.00513.Warner E, Hill K, Causer P, Plewes D, Jong R, Yaffe M. Prospective study of breast cancer incidence in women with a BRCA1 or BRCA2 mutation under surveillance with and without magnetic resonance imaging. J Clin Oncol Off J Am Soc Clin Oncol. 2011;29(13):1664—9. Doi: 10.1200/JCO.2009.27.08354.Lubinski J, Kotsopoulos J, Moller P, Pal T, Eisen A, Peck L, и др. MRI Surveillance and Breast Cancer Mortality in Women With BRCA1 and BRCA2 Sequence Variations. JAMA Oncol. 2024;10(4):493—9. Doi: 10.1001/jamaoncol.2023.69445.Knerr S, Guo B, Wernli KJ, Mittendorf KF, Feigelson HS, Gilmore MJ, и др. Longitudinal adherence to breast cancer surveillance following cancer genetic testing in an integrated health care system. Breast Cancer Res Treat. 2023;201(3):461—70. Doi: 10.1007/s10549-023-07007-w6.Naghi LA, Culver JO, Ricker C, Sturgeon D, Kingham K, Hodan R, и др. Breast Cancer MRI Screening of Patients After Multiplex Gene Panel Testing. JAMA Netw Open. 2025;8(1):e2454447. Doi: 10.1001/jamanetworkopen.2024.544477.Schneider JL, Goddard KAB, Muessig KR, Davis JV, Rope AF, Hunter JE, и др. Patient and provider perspectives on adherence to and care coordination of lynch syndrome surveillance recommendations: findings from qualitative interviews. Hered Cancer Clin Pract. 2018;16:11. Doi: 10.1186/s13053-018-0090-48.Burton-Chase AM, Hovick SR, Peterson SK, Marani SK, Vernon SW, Amos CI, и др. Changes in screening behaviors and attitudes toward screening from pre-test genetic counseling to post-disclosure in Lynch syndrome families. Clin Genet. 2013.;83(3):215—20. Doi: 10.1111/cge.120919.Seppälä TT, Burkhart RA, Katona BW. Hereditary colorectal, gastric, and pancreatic cancer: comprehensive review. BJS Open. 2023;7(3). Doi: 10.1093/bjsopen/zrad023