Insurers to consider hereditary cancer test results?

According to recent news reports, the UK's Association of British Insurers (ABI) may seek permission to use the results of predictive genetic tests for inherited breast and ovarian cancer, to set insurance premiums.

Mutated versions of the genes BRCA1 and BRCA2 are known to confer a high risk of breast and ovarian cancer to carriers. Genetic mutations currently account for around five per cent of breast cancer cases and ten per cent of ovarian cancer. In 2004, 4635 women in the UK were tested for BRCA mutations, around 1000 of which were predictive tests carried out on women with a family history of breast cancer.

There is a moratorium in place until 2011, voluntarily agreed between the ABI and the UK Government, which restricts the use of genetic information in setting insurance policies. The moratorium prevents insurance companies from using genetic information to calculate insurance premiums below £500,000 for life insurance, £300,000 for critical illness and £30,000 for income protection policies. If insurance companies want to access genetic information to set premiums above these rates they need to seek permission from the government advisory body - the Genetics and Insurance Committee (GAIC). GAIC has only approved one such application, which allows insurance companies to request genetic test results for Huntington's disease in life insurance policies over £500,000.

There is a fear that if genetic test results can be accessed by insurance companies and employers then people will be deterred from taking predictive tests and participating in research. A survey conducted by the charity Breakthrough for Breast Cancer in 2005, showing that approximately one third of women with a family history of breast cancer would not take the genetic test if their insurance company was allowed to access the data, goes some way to confirm this fear.

Legislation to prohibit genetic discrimination in insurance and employment is expected to be in place in the US by the end of 2007. There have been several calls for similar legislation to be implemented in the UK. In the meantime, moves to allow genetic test results for BRCA mutations to be used by insurers are likely to be met with fierce opposition from patient interest groups.