Screening all women for cancer genes may be cost-effective

Screening all women over 30 years age for breast and ovarian cancer gene mutations can be cost effective and could also prevent more of these cancers than just screening those at genetic high-risk, suggests a study led by an Indian-origin researcher.

The most well-known breast and ovarian cancer causing genes are BRCA1 and BRCA2, and women carrying either of the gene mutation have approximately a 17-44 per cent chance of developing ovarian cancer and a 69-72 per cent chance of developing breast cancer over their lifetime.

Conversely, for women who do not carry these mutations, the risk is two per cent for ovarian cancer and 12 per cent for breast cancer over their life time.
The current clinical approach to genetic testing is based on having a personal or family history of breast or ovarian cancer.

The new approach, published in the Journal of the National Cancer Institute, showed that it is cost-effective, and as a result can ensure that more women can take preventative action to reduce their risk or undertake regular screening and thus can provide huge new opportunities for cancer prevention and changes in the way how cancer genetic testing is delivered.

"Our findings support the concept of broadening genetic testing for breast and ovarian cancer genes across the entire population, beyond just the current criteria-based approach," said Ranjit Manchanda, Consultant Gynaecological Oncologist, at the Queen Mary University of London.

"Our analysis shows that population testing is the most cost-effective strategy and can have important implications given the effective options that are available for ovarian and breast cancer risk management and prevention for women at increased risk," added Rosa Legood, Associate Professor at the London School of Hygiene and Tropical Medicine.

Furthermore, the researchers found that implementing a programme to test all British women over 30 years age could result in 17,000 fewer ovarian cancers and 64,000 fewer breast cancers.

According to the World Health Organization, out of the 8.8 million deaths overall cancer deaths worldwide in 2015, breast cancer accounted for 571,000 deaths.

Ovarian cancer, with the lowest survival rate of all gynaecological cancers, is diagnosed annually in nearly a quarter of a million women globally and is responsible for 140,000 deaths each year.