USPSTF Recommendation Updates for Women With BRCA-Related Cancer
Posted: Monday, September 16, 2019
The U.S. Preventive Services Task Force (USPSTF) recommends that primary care physicians assess women with a brief familial risk assessment tool if they have a personal or family history of breast, ovarian, tubal, or peritoneal cancer or an ancestry associated with BRCA1/2 mutations. Those who have a positive result upon the risk assessment should then receive genetic counseling and potentially genetic testing. These updates to the 2013 recommendations were published in JAMA.
To establish these recommendations, the USPSTF reviewed evidence regarding risk assessment, genetic counseling, and genetic testing for BRCA1/2 mutations in asymptomatic women who have never been diagnosed with a BRCA-related cancer in addition to those with a previous diagnosis of breast, ovarian, tubal, or peritoneal cancer who were considered to be cancer free. Interventions that may reduce the risk of these diseases were also considered, including intensive screening, medication, and risk-reducing surgery.
There is moderate evidence promoting the benefits of risk assessment, genetic counseling, and interventions for women who have an increased risk for mutations in the BRCA1/2 genes or who have a known history of mutations in BRCA1/2. For women who have no personal or family history suggesting BRCA1/2 mutations, there are small to no benefits of risk assessment, counseling, testing, or interventions. Additionally, there is the potential for small to moderate harm to all patients from administration of risk assessment, counseling, testing, and interventions.
The USPSTF recommendation for screening, counseling, and interventions in women with BRCA1/2 mutations received a B rating, compared with the D rating for screening, counseling, and interventions in women with no BRCA1/2 mutations.
Disclosure: The study authors’ disclosure information may be found at uspreventiveservicestaskforce.org.
