28 Aug USPSTF Issues Genetic Testing Recommendations for BRCA-Related Cancers
MedicalResearch.com Interview with:
Dr. Carol Mangione, M.D., M.S.P.H., F.A.C.P.
Division Chief of General Internal Medicine and Health Services Research
Professor of Medicine
Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in Medicine David Geffen School of Medicine University of California, Los Angeles (UCLA)
Professor of public health at the UCLA Fielding School of Public Health.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Every year, too many American women are faced with the challenge of dealing with a cancer diagnosis related to potentially harmful mutations of the BRCA1 and BRCA2 genes. However, the Task Force found that there are several steps women can take to determine if they’re potentially at increased risk for BRCA gene mutations – and if genetic counseling and BRCA testing are needed.
It is important to note that while some women can benefit from risk assessment, counseling, and testing, these services are not for everyone.
MedicalResearch.com: What should readers take away from your report?
Response: The Task Force recommends that women who have a personal or family history of certain types of cancer—or who have an ancestry associated with BRCA mutations— undergo risk assessment for BRCA mutations. If this assessment suggests that a woman is at increased risk, she should consider genetic counseling and, if indicated after counseling, BRCA genetic testing. On the other hand, if a woman does not have a personal or family history or ancestry associated with BRCA mutations, she should not undergo risk assessment, genetic counseling, or genetic testing for BRCA-related mutations.
Whether or not the harms of risk assessment, counseling, testing, and interventions outweigh the benefits depends on a woman’s individual risk profile and family history. That is why it is important for women to talk to their doctors to determine what’s best for them.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: The Task Force identified several areas in which more research is needed. Of note, more studies are needed that show the impact of genetic testing after the process is complete, including in diverse populations. For women who have a BRCA mutation associated with an increased risk of cancer, more studies are needed that examine the effectiveness of intensive cancer screening and risk-reducing medications, as well as the effects of age at intervention, on improving long-term outcomes.
MedicalResearch.com: Is there anything else you would like to add?
Response: It is important to remember that this recommendation involves several steps, starting with a risk assessment. Each step in the process is complex and comes with its own benefits and harms. Some women might choose to forgo counseling or testing depending on what they learn during the process and their own preferences.
If a woman learns she has a BRCA mutation, she can undergo several interventions to lower her risk for cancer; however, management of BRCA mutations is beyond the scope of this recommendation.
US Preventive Services Task Force. Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322(7):652–665. doi:10.1001/jama.2019.109
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