Current
best practices and rationalistic perspectives in causation-based
prevention, early detection and multidisciplinary treatment
of breast and gastric cancer
Gastric
& Breast Cancer
DOI: 10.2122/gbc.2005.0040
VIEWPOINT
The complexity in deciding for BRCA genetic testing – insurance coverage and risks of missing young carriers by strict criteria
Ioannis Georgiou, PhD, Michael Fatouros, MD, Ioannis Arampatzis, MD, Demosthenis Ziogas, MD, Evangelos Paraskevaidis, MD, Angelos M Kappas, MD, Dimitrios H Roukos, MD.
Abstract
Criteria suggestive of hereditary breast ovarian cancer (HBOC) syndrome that warrant genetic testing are not consistent. The body of literature data is limited and evidence about cost-effectiveness of genetic testing is lacking. Insurance coverage of genetic testing among various countries is not clear and the thresholds (10 to 20%) of the probability for positive genetic testing considerably vary in the national recommendations from UK , US, Germany and Sweden .
Should more or less strict clinical criteria used for decisions about genetic testing? Considering the risk of missing a young BRCA carrier and the associated high risk of death for this woman on one hand and the high costs and insurance coverage of the other, we attempt to approach this key question.
