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Education Disparity

If Debbie McCarron's doctor had been able to interpret the results of her genetic test results correctly, then she may have been able to get timely surgery and avoid experiencing a recurrence of breast cancer, reports Robert Langreth at Bloomberg. In the article, Langreth highlights McCarron's story: After surviving breast cancer, McCarron was advised to get tested for hereditary gene mutations linked to breast and ovarian cancer via Myriad's BRACAnalysis test. McCarron's oncologist Haresh Jhangiani says he only saw the portion of the three-page test results, which reported that McCarron was negative for large rearrangements in BRCA 1 and BRCA 2 genes associated with heightened risk of breast and ovarian cancer. The other portion reported McCarron was positive for a BRCA mutation gauged by Myriad's primary BRACAnalysis test.

Langreth's article focuses on the growing disparity between the commercial availability of genetic tests, which currently number around 2,700, and physician education. According to a survey by ARUP Laboratories, physicians made mistakes in handling 30 percent of the complex genetic tests they ordered between February and December 2010.

Of course, developers of genetic tests also have a role to play in ensuring their products are being used appropriately. Our sister publication Pharmacogenomics Reporter has reported on Myriad's marketing practices for BRACAnalysis targeting OB-GYNs and oncologists, a main component of which focuses on urging doctors to counsel their patients themselves instead of referring them to a genetic counselor outside the medical practice. Myriad employed this strategy after noticing that patients don't always follow through the genetic counseling referrals, and end up not getting tested at all.

During its latest call with investors to discuss the firm's fiscal year 2012 earnings, Myriad officials said the company was initiating a program to analyze how to best integrate genetic counseling in oncologists' offices. "This program is focused on a systematic analysis of a physicians practice to develop the most effective and efficient ways to identify and counsel patients at risk for hereditary cancers," Mark Capone, president of Myriad Genetic Labs, said. "This is particularly important in an oncology practice that likely orders genetic tests, but not on all appropriate breast and colon cancer patients."

The company has already conducted a similar program for select OB-GYN offices, which resulted in a six-fold increase in physician ordering of Myriad's genetic tests. However, during the earnings call, Myriad officials did not comment on whether these physicians were ordering tests and interpreting results correctly.

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