Researchers pinpoint causes for spike in breast cancer genetic testing
A sharp rise in the number of women seeking BRCA genetic testing to evaluate their risk of developing breast cancer was driven by multiple factors, including celebrity endorsement, according to researchers at the University of Georgia (UGA).
According to medicalxpress.com, Adam Zhuo Chen, an associate professor of health policy and management at UGA’S College of Public Health and lead author on the study, said, “BRCA testing and counseling provide important information on the risk of developing breast and ovarian cancers among women with family history of the cancers.
“Appropriate use of BRCA testing would lead to reduction in avoidable cancer mortalities and morbidities.”
Women with hereditary BRCA gene mutations have a 45 to 65 percent risk of developing breast cancer before the age of 70, compared to seven percent in the general population, according to the National Cancer Institute.
Chen and his colleagues wanted to understand the trends in BRCA testing costs and utilization.
Their study analyzed testing rates, payment to the provider, and out-of-pocket costs for patients from 2003 to 2014, and compared findings to reported revenue from Myriad Genetics, the only provider of the test until 2013.
Overall, BRCA testing increased 80-fold during those 11 years, with a large spike in testing occurring in 2013.
That same year Hollywood actress Angelina Jolie published an oped in The New York Times promoting BRCA gene testing and the Supreme Court struck down the patent on BRCA gene testing.
Chen said, “This could provide insights on the impact of the policy changes and the media coverage of celebrity endorsement.”
Current US Preventive Services Task Force guidelines recommend BRCA testing for women at high risk, and the Affordable Care Act requires most private health plans to provide in-network coverage to women with family history of breast and ovarian cancer without cost-sharing for BRCA genetic counseling as a preventive service for women.
Chen added, “Though it may be tempting to connect the whirlwind of media coverage surrounding Jolie’s decision to have a double mastectomy following a positive BRCA test, the available data cannot point to which event had a greater impact.
“Jolie’s op-ed, the Supreme Court decision on BRCA gene and the USPSTF recommendation occurred in a very compact timeline.”
His team has done some analyses examining the difference in the use of BRCA testing among women at elevated risk versus women at low risk, but any significant differences were hard to tease out from available data.
Chen said, “In a companion study, we did examine whether women had follow-up surgical procedures and found an urban and rural disparity in the follow-up rates.
“Women residing in urban areas consistently had a higher rates of follow-up surgical procedures than those in rural areas, though the gap is narrowing.”
As genetic testing becomes more accessible, Chen saw potential for individuals to make more informed decisions about their health.
He said, “We live in a fortunate time where technology advances have greatly improved the quality of human life.”