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ACOG Offers Guidelines on Inherited Cancer Syndrome Screening

NEW YORK (GenomeWeb News) – The American College of Obstetricians and Gynecologists and the Society of Gynecologic Oncologists recently released an April 2009 Practice Bulletin suggesting physicians routinely screen patients for hereditary breast and ovarian cancer syndrome and refer those suspected of having the syndrome to a clinician specializing in genetics.

The document provide information about obstetricians' and gynecologists' role in identifying, managing, and counseling patients with hereditary breast and ovarian cancer syndrome — an inherited condition that increases an individual's risk of breast, ovarian, and other cancers. For instance, it outlines specific questions about personal and family history that can help physicians identify individuals most likely to benefit from a more complete genetic-risk assessment.

Most families with the syndrome carry mutations in the tumor suppressor genes BRCA1 and BRCA2. Such mutations are more common in Ashkenazi Jews, French Canadians, Icelanders, and other populations founded by small groups.

The guidelines recommend genetic-risk assessment for women believed to have a 20 percent to 25 percent chance of inheriting the syndrome, as determined by initial screening and factors such as personal and family history, and ethnicity. It also suggests genetic-risk assessment might be appropriate for women with a lower risk — five percent to 10 percent — of having the syndrome, based on personal and family history combined with clinical criteria.

For individuals who do have the syndrome, the Practice Bulletin outlines strategies for cancer screening and possible prevention plans based on individual risk and family history. It also highlights the importance of genetic counseling before testing to discuss possible outcomes, treatment options, such as chemoprevention or risk-reducing surgery, as well as insurance, family and personal issues related to genetic test results.

Myriad Genetics, which offers BRACAnalysis testing to assess BRCA1 and BRCA2 genes and could potentially benefit from the guidance, applauded the ACOG recommendations in a statement issued yesterday.

"These new guidelines will raise physician awareness of the importance of routine hereditary breast and ovarian cancer assessment,"' Gregory Critchfield, president of Myriad Genetic Laboratories, said in a statement. "'BRACAnalysis testing made available to at-risk patients is an important tool in helping to lower their risks of developing cancer."

In early Wednesday trade on the Nasdaq, shares of Myriad were up 7 percent at $86.67.