Underdiagnosis of Hereditary Breast and Ovarian Cancer in Medicare Patients: Genetic Testing Criteria Miss the Mark

Annals of Surgical Oncology
Shan YangRobert L Nussbaum

Abstract

An estimated 5-10% of breast and ovarian cancers are due to hereditary causes such as hereditary breast and ovarian cancer (HBOC) syndrome. Medicare, the third-party payer that covers 44 million patients in the United States, has implemented a set of clinical criteria to determine coverage for the testing of the BRCA1 and BRCA2 genes. These criteria, developed to identify carriers of BRCA1/2 variants, have not been evaluated in the panel testing era. This study investigated a series of Medicare patients undergoing genetic testing for HBOC to determine the efficacy of genetic testing criteria in identifying patients with hereditary risk. This study retrospectively examined de-identified data from a consecutive series of Medicare patients undergoing genetic testing based on personal and family history of breast and gynecologic cancer. Ordering clinicians indicated whether patients did or did not meet established criteria for BRCA1/2 genetic testing. The genetic test results were compared between the group that met the criteria and the group that did not. Patients in families with known pathogenic (P) or likely pathogenic (LP) variants were excluded from the primary analysis. Among 4196 unique Medicare patients, the rate of P/LP v...Continue Reading

References

May 4, 2004·American Journal of Human Genetics·UNKNOWN CHEK2 Breast Cancer Case-Control Consortium
Apr 10, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Sining Chen, Giovanni Parmigiani
Jun 21, 2013·Breast Cancer Research and Treatment·D Gareth R EvansAnthony Howell
Jan 1, 2015·Journal of the National Cancer Institute·Ephrat Levy-LahadMary-Claire King
Jan 1, 2016·JAMA Oncology·Barbara M NorquistMichael J Birrer
Mar 16, 2016·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Nadine TungJudy E Garber
Mar 28, 2017·American Journal of Preventive Medicine·Fangjian GuoYong-Fang Kuo
May 12, 2017·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Keith NykampScott Topper
Jun 6, 2017·The New England Journal of Medicine·Mark RobsonPierfranco Conte
Aug 19, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Christopher P ChildersJames Macinko

❮ Previous
Next ❯

Citations

Mar 4, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Siddhartha YadavFergus J Couch
Apr 23, 2020·Personalized Medicine·Susanne B Haga, Lori A Orlando
May 28, 2020·Obstetrics and Gynecology·David ChelmowJulia Sage O'Hara
Sep 13, 2020·Annals of Surgical Oncology·J Jaime Alberty-OllerElisa Port
May 18, 2019·American Society of Clinical Oncology Educational Book·Siddhartha Yadav, Fergus J Couch
Jul 8, 2019·The Breast Journal·Marie E WoodUNKNOWN International Society of Cancer Risk Assessment and Management
Dec 12, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Peter D BeitschRobert L Nussbaum
Aug 14, 2019·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Holly LaDucaJill S Dolinsky
Sep 26, 2020·Nature Reviews. Clinical Oncology·Ophira GinsburgPaul Brennan
Oct 17, 2020·Annals of Surgical Oncology·Danielle R HellerBrigid K Killelea
Aug 24, 2021·Current Treatment Options in Oncology·Anusha Vaidyanathan, Virginia Kaklamani
Oct 17, 2021·Annals of Surgical Oncology·Abhenil Mittal, Raja Pramanik

❮ Previous
Next ❯

Related Concepts

Related Feeds

Breast Cancer: BRCA1 & BRCA2

Mutations involving BRCA1, found on chromosome 17, and BRCA2, found on chromosome 13, increase the risk for specific cancers, such as breast cancer. Discover the last research on breast cancer BRCA1 and BRCA2 here.

Related Papers

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Peter D BeitschRobert L Nussbaum
Journal of the National Cancer Institute
Bethany L NiellStephen B Gruber
© 2022 Meta ULC. All rights reserved