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Preventive Services Panel Advises Against Broad BRCA Testing: 'Family History' Should Guide Testing

NEW YORK (GenomeWeb News) – An independent clinical advisory panel has recommended against genetic counseling and testing focused for BRCA status for "the vast majority" of American women, and advised that only women who with strong family histories of cancer should talk to their doctors about their risk and possibly getting genetically tested.

The recommendations were released this week by the US Preventive Services Task Force, a panel of non-Federal experts that includes a range of primary care providers and specialists.

While genetic testing for BRCA1 and BRCA2 status can be helpful for women who have a strong family history of breast, ovarian, tubal, or peritoneal cancers, these tests could be harmful for the 90 percent of American women who do not have a family history linked to increased risk for these inherited mutations, the USPSTF said.

Understanding the risk for BRCA-related cancers is an important way to prevent them, the panel found, but these mutations are present in only .2 to .3 percent of women while many other factors can also increase a woman's risk for breast and ovarian cancer.

For women who do have these mutations, the cancer risk is very high, the panel said, and currently available genetic tests work best for these women. For most women, however, there is some harm linked to genetic testing, as the results may be inconclusive and lead them to take unnecessary medications or undergo surgeries.

"Unfortunately, most will not benefit from these interventions and may needlessly suffer great harm, especially because they were never at increased risk to begin with," the USPSTF panel said.

For those reasons, the panel advises against routine genetic counseling and BRCA testing for women without a strong family history of cancer.

"Evidence still shows that there are serious, negative consequences that could result from testing women who are at low risk for BRCA mutations. The BRCA test works best for women who have reviewed their family history of breast or ovarian cancer and the pros and cons of the screening test with a trained professional," Task force Chair Virginia Moyer said in a statement.

"We have great hope in the science of genomics to improve screening practices and even prevent some cancers," Moyer added. "At this point, the evidence shows that most American women will not benefit from genetic counseling or the test for gene mutations in BRCA1 and BRCA2.”

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