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BRCA Risk Often Missed in Ovarian Cancer Patients

Half of those at substantial risk for BRCA mutations are not referred for genetic counseling

THURSDAY, April 22 (HealthDay News) -- Although there has been improvement over time, interpretation of risk for BRCA1 or BRCA2 mutations in ovarian cancer patients, and subsequent referral for genetic counseling, remains poor, with half of substantial-risk patients being missed in 2007, according to research published in the May issue of Obstetrics & Gynecology.

Larissa A. Meyer, M.D., of the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues reviewed the records of 3,765 new ovarian cancer patients from 1999 through 2007. They identified those at substantial risk (more than 20 to 25 percent) for a BRCA1 or BRCA2 mutation and reviewed their records for evidence of referral to genetic counseling.

The researchers found that an average of 23.8 percent of the women were at substantial risk for these mutations. Genetic counseling referrals increased from 12 percent of patients at substantial risk in 1999 to 48 percent in 2007. Women who were newly diagnosed were more likely to be referred for genetic counseling than new patients with recurrent disease or those seen as second opinions. African-American women were less likely to receive a referral than were Hispanic or white women.

"Given the current and future therapeutic implications, greater attention to developing a systematic process of identifying cancer patients with hereditary cancer syndromes is needed. At-risk individuals should be referred to genetic counseling as an integrated, routine aspect of care. Although physicians traditionally have focused their clinical efforts on cancer therapy, they also have a crucial role in cancer prevention through the identification of individuals with hereditary cancer syndromes," the authors write.

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