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. 2023 Jul 14;10(2):lsad022. doi: 10.1093/jlb/lsad022

Table 7.

Privacy and security top policy options

Issue statement Trust in the security of a commons is difficult to build given that privacy breaches can never be completely eliminated, protections vary by jurisdiction, and laws/regulations/norms protecting privacy change over time. Further, links among data sets are needed to interpret cancer risk, but then the data becomes more identifiable and privacy risks increase.
Top three policy options (label)* Points to consider Illustrative quotes (study ID)
Funders, clinical labs, individual researchers, institutions, and end users of data could adopt federated models of data sharing to avoid having a centralized database, where data are uploaded and downloaded locally, which would minimize the risks of re-identification and reduce harms from security breaches (PS10) Fewer copies = greater security ‘The best improvement on data protection is to have fewer copies of the data requiring protection. Federation is a great step forward for this’ (014)
Need to evaluate tradeoffs (utility) ‘Federated models do reduce the risk - but at what cost to utility (hence why I said, “don’t know” from a feasibility standpoint)’ (022)
Need evidence that federated models work in hereditary cancer context ‘Federated models have a part to play (privacy by design), but risk being interpreted too narrowly (data never moves) and have still not been shown to be feasible outside some health surveillance networks’ (024)
Funders, institutions, and end users of data could invest in the development and use of novel technologies geared toward protecting privacy and enhancing data security (eg leveraging synthetic data to reduce re-identification risk, and leveraging secure computational methods to allow analysis of data without moving data (PS9) Prevention is best ‘Technological measures to prevent data breaches/misuse are the best method of preventing these occurrences’ (001)
Technology is still immature ‘Privacy-preserving technologies have a part to play but remain immature …’ (024)
Need to recognize ‘arms race’ dynamic with bad actors ‘While I think that investing in the development and use of novel technologies geared toward protecting privacy and enhancing data security is a good idea, it is an arms race with no end in sight unless there is lawmaking that removes the incentives to hacking these data’ (012)
Need to weigh tradeoffs (utility) ‘Technical safeguards (eg differential privacy, homomorphic encryption, secure multiparty computation, federated learning) can offer measurable, effective privacy protection but they have a cost in terms of computational efficiency, accuracy of results, and administrative overhead’ (021)
Faux ideology of effective technology ‘[E]veryone wants magic tech to fix this, but I haven’t seen any of that tech work at anything approaching meaningful scale’ (015)
Data resources, institutions and individual researchers could be more transparent about security risks and potential harms (PS8) Transparency may lead to public pressure on lawmakers ‘Research on privacy risks and costs will help spur lawmaking as will greater transparency (and the public awareness that comes with it)’ (012)
Need balanced, non-alarmist messaging ‘Along with the idea of being more transparent about risks and harms, it is important also to mention benefits and gains’ (010)
Transparency alone is not a solution ‘Just being more transparent/clear about the risks seems to do little to solve the problem’ (022)

*See supplementary tables for all policy options labeled by domain (number), eg PS1 for the first list policy option in the privacy and security domain.