Rise in Breast Cancer Gene Testing Linked to Celebrity Endorsements

Study analyzes the different factors that have increased the rate of women undergoing breast cancer genetic testing.

The number of women who seek genetic testing to evaluate their risk of developing breast cancer has witnessed a sharp increase. This trend was driven by several factors including celebrity endorsements, says study conducted at University of Georgia.

"BRCA testing and counseling provide important information on the risk of developing breast and ovarian cancers among women with family history of the cancers," said Zhuo "Adam" Chen, an associate professor of health policy and management at UGA’s College of Public Health and lead author on the study. "Appropriate use of BRCA testing would lead to reduction in avoidable cancer mortalities and morbidities."

Research Suggests Negative BRCA Testing May Not Always Imply Lowered Breast Cancer Risk
Women who test negative for the family-specific BRCA2 mutations are still at greater risk for developing breast cancer, research suggests.

‘BRCA gene testing increased 80-fold during 2003 to 2014, with a large spike in testing occurring in 2013, the year that Angelina Jolie promoted breast cancer screening and testing.’

Women with hereditary BRCA gene mutations have a 45 to 65 percent risk of developing breast cancer before age 70, compared to 7 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.

Risk Reduction and Screening for Ovarian Cancer Among Women Following BRCA Testing Examined By Study
According to a report, following RCA testing, many women who are non-BRCA carriers undergo risk-reducing procedures and additional ovarian cancer screenings, despite limited data.

That same year Hollywood actress Angelina Jolie published an op-ed in The New York Times promoting BRCA gene testing and the Supreme Court struck down the patent on BRCA gene testing.

"This could provide insights on the impact of the policy changes and the media coverage of celebrity endorsement," said Chen.

BRCA Testing on the Rise for Women Without Breast, Ovarian Cancer
Women considered high-risk based on personal or family history for breast and ovarian cancer should undergo BRCA testing.

Current U.S. 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.

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, Chen says the available data cannot point to which event had a greater impact.

When Surgery Has Greatest Impact for BRCA Mutation Carriers
Of the women who carry the mutated BRCA1/2 genes, 45-65 percent will develop breast cancer, and 15-39 percent will develop ovarian cancer in their lifetimes.

"Jolie’s op-ed, the Supreme Court decision on BRCA gene and the USPSTF recommendation occurred in a very compact timeline," Chen said.

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.

"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," said Chen. "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 sees potential for individuals to make more informed decisions about their health.

"We live in a fortunate time where technology advances have greatly improved the quality of human life," he said.

Source-Eurekalert