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Ashkenazi Jewish women should be screened for BRCA1 and BRCA2 genes related to breast cancer, according to the recommendation of a US task force announced in an editorial this week in the Journal of the American Medical Association.
According to studies, one Ashkenazi Jew out of 40 has genetic mutations, compared to one in 300 in the general population.
The issue in dispute concerns genes called BRCA1 and BRCA2. When they mutate, the body can not repair the damaged DNA, which greatly increases the risk of breast, ovarian and certain other cancers. Genetic testing allows affected women to take steps to reduce their risk, for example when actress Angelina Jolie underwent a preventive mastectomy several years ago.
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Most cancers are not caused by mutations in the BRCA gene – they account for 5% to 10% of breast cancers and 15% of ovarian cancers – so gene testing is not for everyone . However, the US Task Force on Preventive Services has long been recommending physicians to screen women who have parents with cancer-related BRCA cancers and refer those who might benefit from a genetic test to a genetic counselor to help them make a decision.
Ashkenazi Jewish women belong to these groups.
Identifying carriers of the BRCA mutation "can save lives, and should be part of routine medical care," Drs. Susan Domchek of the University of Pennsylvania and Mark Robson of the Memorial Sloan Kettering Cancer Center, who were not involved in the new guidelines, wrote in an editorial accompanying them.
The editorial also stated that "researchers are actively reporting higher mutation rates of the BRCA1 and BRCA2 genes in various populations than previously."
He also called for an increase in the number of genetic counselors specializing in cancer in the United States.
Carol Mangione, a member of the team at the University of California, Los Angeles, do not miss out on genetic counseling.
BRCA tests can cause anxiety and sometimes confused results, finding mutations that may not be dangerous – things that counselors are trained to interpret. There is a shortage of genetic counselors, especially in rural areas, and she said that telephone counseling can be effective.
There is a wide range of gene tests, some only looking for BRCA mutations and others testing dozens of additional genes at the same time. There is even a consumer kit sold by 23andMe, but Domchek and Robson have warned that it only detects the three most common mutations in women of Ashkenazi Jewish descent, not dozens of mutations.
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