International trends in the uptake of cancer risk reduction strategies in women with a BRCA1 or BRCA2 mutation.

Authors:
Kelly Metcalfe
Kelly Metcalfe
University of Toronto
Toronto | Canada
Andrea Eisen
Andrea Eisen
University of Toronto
Canada
Leigha Senter
Leigha Senter
The Ohio State University Medical Center
Canada
Susan Armel
Susan Armel
University of Toronto
Toronto | Canada
Louise Bordeleau
Louise Bordeleau
University of Toronto
Canada
Wendy S Meschino
Wendy S Meschino
North York General Hospital
Canada
Tuya Pal
Tuya Pal
H. Lee Moffitt Cancer Center and Research Institute
United States
Henry T Lynch
Henry T Lynch
Creighton University School of Medicine
United States

Br J Cancer 2019 Apr 11. Epub 2019 Apr 11.

Women's College Research Institute, Toronto, ON, Canada.

Background: Women with a BRCA1 or BRCA2 mutation face high risks of breast and ovarian cancer. In the current study, we report on uptake of cancer screening and risk-reduction options in a cohort of BRCA mutation carriers from ten countries over two time periods (1995 to 2008 and 2009 to 2017).

Methods: Eligible subjects were identified from an international database of female BRCA mutation carriers and included women from 59 centres from ten countries. Subjects completed a questionnaire at the time of genetic testing, which included past use of cancer prevention options and screening tests. Biennial follow-up questionnaires were administered.

Results: Six-thousand two-hundred and twenty-three women were followed for a mean of 7.5 years. The mean age at last follow-up was 52.1 years (27-96 years) and 42.3% of the women had a prior diagnosis of breast cancer. In all, 27.8% had a prophylactic bilateral mastectomy and  64.7% had a BSO. Screening with breast MRI increased from 70% before 2009 to 81% at or after 2009. There were significant differences in uptake of all options by country.

Conclusion: For women who received genetic testing more recently, uptake of prophylactic mastectomy and breast MRI is significantly higher than those who received genetic testing more than 10 years ago. However, uptake of both BSO and breast MRI is not optimal, and interventions to increase uptake are needed.

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41416-019-0446-1DOI Listing
April 2019

Publication Analysis

Top Keywords

breast mri
12
genetic testing
12
women brca1
8
brca1 brca2
8
ten countries
8
brca2 mutation
8
brca mutation
8
mutation carriers
8
uptake cancer
8
received genetic
8
uptake
6
cancer
5
women
5
breast
5
two-hundred twenty-three women
4
twenty-three women years
4
years
4
follow-up 521
4
years age
4
age follow-up
4

References

(Supplied by CrossRef)
Article in JAMA
KB Kuchenbaecker et al.
JAMA 2017
Article in JAMA
A Finch et al.
JAMA 2006
Article in Journal of Clinical Oncology
Amy P.M. Finch et al.
Journal of Clinical Oncology 2014
Article in N. Engl. J. Med.
M Kriege et al.
N. Engl. J. Med. 2004
Article in JAMA
E Warner et al.
JAMA 2004
Article in J. Clin. Oncol.
E Warner et al.
J. Clin. Oncol. 2001
Article in J. Clin. Oncol.
CK Kuhl et al.
J. Clin. Oncol. 2005
Article in Radiology
F Sardanelli et al.
Radiology 2007
Article in Radiology
CD Lehman et al.
Radiology 2007
Article in Cancer.
CD Lehman et al.
Cancer. 2005
Article in Breast.
AI Hagen et al.
Breast. 2007

Similar Publications