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Hardy MW, Peshkin BN, Rose E, Ladd MK, Binion S, Tynan M, McBride CM, Grinzaid KA, Schwartz MD. Attitudes and interest in incorporating BRCA1/2 cancer susceptibility testing into reproductive carrier screening for Ashkenazi Jewish men and women. J Community Genet 2022; 13:281-292. [PMID: 35486291 PMCID: PMC9051789 DOI: 10.1007/s12687-022-00590-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/19/2022] [Indexed: 10/31/2022] Open
Abstract
Pathogenic variants in the BRCA1 and BRCA2 (BRCA1/2) genes are associated with elevated cancer risks in men and women. Due to a founder effect, Ashkenazi Jewish individuals are at higher risk for carrying three specific BRCA1/2 pathogenic variants. There have been recent calls for population screening in this population because many carriers do not have family histories suggestive of hereditary cancer. One approach could be to integrate optional BRCA1/2 testing into routinely offered reproductive carrier screening for recessive and X-linked disorders. However, the differing goals of these types of testing (i.e., personal health risks versus family planning) raise questions about the implications for patient education and informed consent. To this end, we aimed to determine interest, attitudes, and preferences regarding integrating such testing by electronically surveying 331 Ashkenazi Jewish participants in JScreen - a national, not-for-profit, at-home carrier screening program focused on genetic risks in Jewish communities. We found that while 41% of participants had plans to pursue BRCA1/2 testing, 93% would have opted for such testing if offered as an add-on to reproductive carrier screening. This was particularly true of those with higher perceived cancer risk and more positive attitudes toward genetic testing. With respect to preferences about delivery of this service, more than 85% of participants preferred remote (telephone, print, or web-based) genetic education rather than traditional genetic counseling. These results suggest that offering optional BRCA1/2 testing within the context of reproductive carrier screening might provide opportunities for cancer prevention without overburdening scarce genetic counseling resources.
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Affiliation(s)
- Melanie W Hardy
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Beth N Peshkin
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, 20007, USA
| | - Esther Rose
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Mary Kathleen Ladd
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, 20007, USA
| | - Savannah Binion
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, 20007, USA
| | - Mara Tynan
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, 20007, USA
| | - Colleen M McBride
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Karen A Grinzaid
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Marc D Schwartz
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, 20007, USA.
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