Should More Ashkenazi Jews Get Tested for Cancer-Causing BRCA Gene Mutations?

Posted By on March 13, 2015

Doctors Split on New Affordable Screening Initiative

Anya Ulinich

A new initiative offering subsidized screening for cancer-causing mutations in Ashkenazi Jews including those with no family history of cancer appears to be splitting cancer specialists.

The BRCA community study, sponsored by the Program for Jewish Genetic Health, began accepting applicants in January from Ashkenazi women and men age 25 and older.

Led by Dr. Susan Klugman, medical director of PJGH and director of the reproductive genetics division at Montefiore Health System, the program will offer screenings for mutations in the BRCA1 and BRCA2 genes for just $100, even to those who are considered at low risk for a mutation. The screenings will be offered at the Montefiore Medical Center in the Bronx, and at the centers branches in Larchmont and Hartsdale, both in New York, though Ashkenazim may participate no matter where they reside.

The PJGH initiative is the first of its kind in the United States to provide affordable screening for mutations in the BRCA1 and BRCA2 genes to those who typically face barriers to testing: the low-risk and uninsured. Low-risk people those without a personal or family history of cancer are typically not covered by insurance for this testing and could otherwise pay nearly $600 out of pocket. The program includes the option to participate in an associated research study whose main goals are to identify mutation carriers in the low-risk group who would otherwise go undetected. The program will also assess the psychosocial, religious and cultural issues carriers face.

Dr. Sharon Rosenbaum Smith, a breast surgeon at the Comprehensive Breast Center at Mount Sinai Roosevelt, hailed the program as fabulous because it may uncover women who are unaware they are at risk.

Rosenbaum Smith said that women could be carrying the gene yet have no family history to alert them to their risk because there arent many females in the family [and] the gene is being passed down by men, [so] they arent seeing the breast cancer.

It could also be that there is a lack of communication, that there are breast cancers in the women but they arent telling their family members, she said.

Rosenbaum cautioned that the programs controlled environment, with genetics counselors to help patients understand their individualized cancer risks, is essential. I dont think you should be able to walk into any doctors office and get the test, she said.

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Should More Ashkenazi Jews Get Tested for Cancer-Causing BRCA Gene Mutations?

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