Interest in BRCA1/2 testing in a primary care population.


Journal Article

BACKGROUND: Mutations in the breast cancer susceptibility genes BRCA1 and BRCA2 are found in less than 1/1,000 women in the general population. Experts and professional organizations recommend targeting testing to women with risk factors for carrying a mutation. Over the next decade, BRCA1/2 testing is likely to become substantially less expensive and to move into primary care practice where pretest counseling may be limited. METHODS: The objective of the study was to investigate the factors associated with interest in BRCA1/2 testing among primary care patients receiving only limited information about testing. The design was a cross-sectional mailed survey. The setting was a University-based health system in the metropolitan Philadelphia region. The participants were 400 adult women cared for in a faculty General Internal Medicine practice. RESULTS: Two hundred forty-two women (71%) completed surveys; 53% of respondents were aware of BRCA1/2 testing and 58% were interested in undergoing testing if it was both convenient and affordable. Thirty-one percent were both aware of and interested in testing. Awareness of testing was inversely associated with African-American race (OR 0.56, 95% CI 0.38-0.83) and positively associated with college education (OR 2.21, 95% CI 1.23-3.94). Interest in testing was inversely associated with a family history of breast cancer (OR 0.45, 95% CI 0.23-0.92) and increasing age (OR 0.97, 95% CI 0.95-0.99). The inverse association between family history and interest in testing persisted in the subgroup of women who were aware of testing (OR 0.55, 95% CI 0.30-0.98). CONCLUSIONS: Among a primary care population, African-American women are less aware of BRCA1/2 testing and, when provided only limited information about BRCA1/2 testing, women at lowest risk of carrying a mutation are most interested in undergoing BRCA1/2 testing. Challenges of moving BRCA1/2 testing into primary care practice include both limiting indiscriminate use by the "worried well" and, as proven cancer prevention strategies become available, ensuring access to all high-risk women regardless of race.

Full Text

Duke Authors

Cited Authors

  • Armstrong, K; Weber, B; Ubel, PA; Guerra, C; Schwartz, JS

Published Date

  • June 2002

Published In

Volume / Issue

  • 34 / 6

Start / End Page

  • 590 - 595

PubMed ID

  • 12052018

Pubmed Central ID

  • 12052018

Electronic International Standard Serial Number (EISSN)

  • 1096-0260

International Standard Serial Number (ISSN)

  • 0091-7435

Digital Object Identifier (DOI)

  • 10.1006/pmed.2002.1022


  • eng