Whole-population testing for breast and ovarian cancer gene mutations is cost effective

January 17, 2018, Queen Mary, University of London

Screening the entire population for breast and ovarian cancer gene mutations, as opposed to just those at high-risk of carrying this mutation, is cost effective and could prevent more ovarian and breast cancers than the current clinical approach, according to research published today in the Journal of the National Cancer Institute.

Researchers believe that implementing a programme to all British women over 30 years age could result in thousands fewer cases of ovarian and breast ; up to 17,000 fewer ovarian cancers and 64,000 fewer breast cancers.

The most well-known breast and causing genes are BRCA1 and BRCA2, and women carrying either a BRCA 1 or BRCA2 gene mutation have approximately a 17%-44% chance of developing ovarian cancer and a 69-72% chance of developing breast cancer over their lifetime. The population based risk for women who do not carry the gene mutation is 2% for ovarian cancer and 12% for over their life time. Women who are known to be carriers can manage and reduce their risk of developing cancer by enhanced screening, medical prevention or risk-reducing surgery. The current clinical approach to genetic testing is based on having a personal or family history of breast or ovarian cancer.

Yet research led by researchers from Barts Cancer Institute at Queen Mary University of London and Barts Health NHS Trust, supported by the London School of Hygiene & Tropical Medicine, used complex mathematical models to compare costs and health benefits of different strategies for genetic testing. They compared strategies of population testing for breast and ovarian cancer genes with clinical criteria or family history testing. They found that the most cost-effective strategy was population testing for multiple cancer genes which prevented many more ovarian and breast cancers than current screening methods. They undertook analysis and showed that a new approach of population testing for multiple genes would be cost-effective for both UK and US health systems.

Dr Ranjit Manchanda, Consultant Gynaecological Oncologist, Barts Cancer Institute at Queen Mary University of London, and Barts Health NHS Trust, UK, says: "Recent advances in genomic medicine offer us the opportunity to deliver a new population-based predictive, preventive and personalized medicine strategy for cancer prevention. Our findings support the concept of broadening genetic testing for breast and ovarian cancer across the entire population, beyond just the current criteria-based approach. This could prevent thousands more breast and ovarian cancers than any current strategy, saving many lives.

"With the costs of testing falling this approach can ensure that more women can take preventative action to reduce their risk or undertake regular screening. As knowledge and societal acceptability of this type of testing increases, it can in the future provide huge new opportunities for cancer prevention and changes in the way we deliver cancer genetic testing."

Dr Rosa Legood, Associate Professor Health Economics, London School of Hygiene and Tropical Medicine says: "Our analysis shows that population testing for breast and ovarian cancer gene mutations is the most cost-effective strategy which can prevent these cancers in high risk women and save lives. This approach can have important implications given the effective options that are available for ovarian and cancer risk management and prevention for women at increased risk."

Athena Lamnisos, CEO, The Eve Appeal, says: "These research findings demonstrate the potential for both saving lives and costs. Whole-population is cost-effective. If women identified as high risk act on the information that they're given, in terms risk reducing surgery, their lifetime risk of developing these -specific cancers can be reduced. The impact that this study could have on healthcare in the future for these cancers is promising and an exciting step forward in prevention. "

Explore further: Genetic predisposition to breast cancer due to non-brca mutations in ashkenazi Jewish women

More information: Ranjit Manchanda et al, Cost-effectiveness of Population-Based BRCA1, BRCA2, RAD51C, RAD51D, BRIP1, PALB2 Mutation Testing in Unselected General Population Women, JNCI: Journal of the National Cancer Institute (2017). dx.doi.org/10.1093/jnci/djx265

Related Stories

Genetic predisposition to breast cancer due to non-brca mutations in ashkenazi Jewish women

July 20, 2017
Genetic mutations in BRCA1 and BRCA2 increase the risk of breast and ovarian cancer in Ashkenazi Jewish women. A new article published by JAMA Oncology examines the likelihood of carrying another cancer-predisposing mutation ...

Risk-reducing mastectomy questioned for BRCA mutation carriers with prior ovarian cancer

July 11, 2017
Mutations in the BRCA gene correspond to a higher lifetime risk of developing breast and ovarian cancers, and many women who carry these mutations consider undergoing mastectomy or removal of the ovaries and fallopian tubes ...

Ovarian cancer: Genetic testing should be accessible to all women with the disease

April 15, 2015
The genes BRCA1 and BRCA2 play a significant role in hereditary breast and ovarian cancers. Recent media attention has focused on American actress Angelina Jolie's decision to have her ovaries and fallopian tubes surgically ...

New study for women with family history of breast, ovarian cancer

May 2, 2016
A new clinical study by Winship Cancer Institute of Emory University seeks to increase the number of women at hereditary risk for breast and ovarian cancer who are seen for genetic counseling services.

Family history and location of genetic fault affect risk for carriers of cancer genes

June 20, 2017
A large scale study of women carrying faults in important cancer genes should enable doctors to provide better advice and counselling for treatments and lifestyle changes aimed at reducing this risk.

Threshold for pre-emptive surgery to curb ovarian cancer risk should be halved

June 27, 2016
The current threshold for pre-emptive surgery to remove the ovaries and fallopian tubes of women aged 40+ at high risk of developing ovarian cancer should be halved, concludes research published online in the Journal of Medical ...

Recommended for you

Fully reprogrammed virus offers new hope as cancer treatment

May 25, 2018
A cancer treatment that can completely destroy cancer cells without affecting healthy cells could soon be a possibility, thanks to research led by Cardiff University.

Research could help fine-tune cancer treatment

May 25, 2018
Cancer therapies that cut off blood supply to a tumour could be more effective in combination with existing chemotherapeutic drugs—according to new research from the University of East Anglia.

Increasing physical activity linked to better immunity in breast cancer patients, study finds

May 25, 2018
A new study from the University of Toronto's Faculty of Kinesiology & Physical Education has found that moderate to vigorous physical activity may help regulate the levels of C-reactive protein – an important biomarker ...

Low-fat diet tied to better breast cancer survival

May 24, 2018
(HealthDay)—Breast cancer patients who adopted a low-fat diet were more likely to survive for at least a decade after diagnosis, compared to patients who ate fattier fare, new research shows.

A cascade of immune processes offers insights to triple-negative breast cancer

May 24, 2018
Cancer is crafty. To survive and thrive, tumors find a way of thwarting our body's natural systems.

By forming clots in tumors, immune cell aids lung cancer's spread

May 24, 2018
University of North Carolina Lineberger Comprehensive Cancer Center researchers have found that by helping to form clots within tumors, immune cells that flock to a particular type of lung cancer are actually building a foundation ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.