A research team based at Queen Mary, University of London (QMUL) has found that testing all women over 30 for mutations in the BRCA genes could prevent millions of deaths from breast and ovarian cancer, as well as proving cost-effective in middle and high-income countries. In the UK, the researchers model that this approach could save almost 12,000 lives.
Professor Ranjit Manchanda, lead author on the study, said: 'General population BRCA testing can bring about a new paradigm for improving global cancer prevention. Why do we need to wait for people to develop a preventable cancer to identify others in whom we can prevent cancer?'
Mutations in the BRCA gene cause ten to 20 percent of ovarian and six percent of breast cancers. Identifying carriers before they develop disease can lead to early detection and/or prevention of breast and ovarian cancer through increased screening, drugs and preventative surgery. Current guidelines only recommend testing 'high-risk' potential carriers for BRCA mutations: women who have a strong family history of breast or ovarian cancer. However, 50 percent of BRCA mutation carriers do not meet the current testing criteria, and over 97 percent of BRCA mutation carriers in the UK remain unidentified.
'Strategies and pathways for population testing must be developed to enable population genomics to achieve its potential for maximising early detection and cancer prevention' said Professor Manchanda.
Large-scale population screening is not without risk. Baroness Delyth Morgan, chief executive of the charity Breast Cancer Now, told inews: 'Undergoing testing for genetic changes that increase your cancer risk can be a very anxious process for many, which would need to be carefully considered, including identifying what additional support may need to be provided.'
Further, Professor Nora Pashayan, from the Department of Applied Health Research at University College London, who was not involved in the study, also cautioned: 'Not everyone who has BRCA1/BRCA2 mutation will eventually develop breast or ovarian cancer. Offering treatment to all risks overtreatment. This comes at financial and psychological cost. This should be accounted for.'