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Viewpoint |

Cost-effectiveness of Universal BRCA1/2 Screening Evidence-Based Decision Making

Elisa F. Long, PhD1; Patricia A. Ganz, MD2,3
[+] Author Affiliations
1Anderson School of Management, University of California, Los Angeles
2Division of Cancer Prevention and Control Research and Jonsson Comprehensive Cancer Center, University of California, Los Angeles
3Fielding School of Public Health, University of California, Los Angeles
JAMA Oncol. 2015;1(9):1217-1218. doi:10.1001/jamaoncol.2015.2340.
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This Viewpoint discusses whether a broad genetic testing program for BRCA1/2 is realistic in terms of the relative value and costs of such a program.

Of the 233 000 breast cancers diagnosed annually in the United States, 5% to 10% are attributable to mutations in the BRCA1 or BRCA2 genes.1 Breast cancers in BRCA mutation carriers are characterized by younger age at onset, bilateral occurrence, and more aggressive subtypes, such as “triple-negative.”1 Female mutation carriers face a 45% to 65% breast cancer risk by age 70 years, and an ovarian cancer risk ranging from 10% to 17% (BRCA2) to 39% (BRCA1). Women found to be BRCA mutation carriers—either through genetic screening or following a cancer diagnosis—may choose to undergo bilateral risk-reducing mastectomy (RRM) and/or salpingo-oophorectomy (RRSO) as an alternative to increased surveillance or chemoprevention. Knowledge of a genetic mutation may have a further impact on fertility decisions, including oocyte retrieval and genetic testing prior to cryopreservation or embryo implantation.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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