USPSTF: draft supports screening for BRCA risk in primary care

  • U.S. Preventive Services Task Force

  • Oncology guidelines update
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Takeaway

  • A draft statement from the US Preventive Services Task Force (USPSTF) recommends that women who have relatives with BRCA-related cancers (breast, ovarian, fallopian tube, peritoneal, or pancreatic) or who have an ethnicity/ancestry linked to BRCA1 or BRCA2 gene mutations should be screened in primary care to determine whether they are at elevated risk for BRCA mutations.
  • A positive screen warrants referral to genetic counseling and, if indicated, genetic testing.
  • The USPSTF still recommends against routine screening, genetic counseling, and testing of women without a family or personal history or ethnicity/ancestry that puts them at increased risk for BRCA mutations.

Why this matters

  • Women who test positive for BRCA mutations may reduce their risk for breast and ovarian cancer by several methods: more frequent screening, risk-reducing medications, or risk-reducing surgery.

Key points

  • The scientific basis of the USPSTF draft recommendation is from an evidence synthesis.
  • Primary care screening should rely on validated risk assessment tools such as the Ontario Family History Assessment Tool or the Manchester Scoring System, among others.
  • 1 in 300-500 women carry BRCA mutations, accounting for 5%-10% of breast cancer and 15% of ovarian cancer cases.
  • This USPSTF recommendation is more expansive than its 2013 recommendation by including women with ethnicity/ancestry linked to BRCA mutations.

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