Genetic testing for BRCA1/2 mutations is still underutilized in US patients with breast and ovarian cancer, according to a study published in the Journal of the National Comprehensive Cancer Network.
The study showed that germline genetic testing for BRCA1/2 mutations has increased in recent years. However, between January 2011 and March 2020, about half of eligible patients with breast cancer and about one-third of eligible patients with ovarian cancer underwent testing within a year of diagnosis.
This study included 12,074 patients from the Flatiron Health database. A total of 2982 patients with breast cancer and 5563 patients with ovarian cancer were eligible for genetic testing.
Over the entire study period, 56.4% of eligible breast cancer patients and 35.4% of eligible ovarian cancer patients underwent genetic testing within a year of diagnosis.
The proportion of breast cancer patients who underwent testing within a year increased from 37.0% in 2011 to 67.9% in 2020. The proportion of ovarian cancer patients who underwent testing within a year increased from 23.0% in 2011 to 52.9% in 2020.
Among the breast cancer patients, genetic testing was less likely in older patients (relative risk [RR], 0.93; 95% CI, 0.90-0.96, for every 5 years) and those on Medicare (RR, 0.69; 95% CI, 0.49-0.96 vs commercial insurance).
Among patients with ovarian cancer, genetic testing was less likely in older patients (RR, 0.95; 95% CI, 0.93-0.97, for every 5 years) and Black patients (RR, 0.80; 95% CI, 0.65-0.98 vs White patients).
“This study demonstrates ongoing underutilization and sociodemographic disparities in GT [genetic testing] among a nationwide cohort of patients with breast and ovarian cancers,” the researchers wrote. “Although GT has increased over time, additional work is needed to design, implement, and evaluate strategies to ensure that all eligible patients receive GT.”
Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Lau-Min KS, McCarthy AM, Nathanson KL, Domchek SM. Nationwide trends and determinants of germline BRCA1/2 testing in patients with breast and ovarian cancer. J Natl Cancer Inst. 2023;21(4):351-358.e4. doi:10.6004/jnccn.2022.7257