Cancer Risk Assessment Scores: Personalized Risk and Mundane Genomics

This chapter argues that cancer risk assessment scores are becoming more individualized as well as mundane, organizing risk in more personalized ways through the production of “your” score, based on your risk factors, an emerging multi-omic paradigm, your genome. We begin by discussing “lifetime risk”, a common concept in risk scoring, and then turn to the implications of risk factors and surveillance medicine for determining health. The chapter addresses the complexity of current risk calculation tools, including the polygenic risk score, the use of vital statistics, genome-wide association studies, and existing databases. We argue that as disease risk scoring and genetic screenings are being normalized and made commonplace, appearing in People Magazine, on myriad websites, in doctor’s offices, through health advocacy organizations, and in direct-to-consumer genomic risk assessment companies, people are subjected to personalized surveillance in new ways. The incorporation of the scores into people’s everyday lives shapes temporalities as well as subjectivities, emphasizes responsibility, incorporates ideals of rational decision-making, and for some, fosters anxiety. Genetic risk and statistical probabilities, we conclude, are increasingly accepted and ordinary ways to govern life, despite their fraught and multiple calculations.