Missing Opportunities to Prevent Ovarian Cancer

By Eleanor Griffith, MS, CGC · Sep 2018

Approximately 1 in 5 women diagnosed with ovarian cancer have an inherited mutation that helps explain why ovarian cancer developed. About two-thirds of the time, that mutation will be in a BRCA gene. Genetic testing for women with ovarian cancer can guide treatment options, provide information about other cancer risks, and provide valuable information for family members.

Cancer Patients Are Often Not Offered Appropriate Genetic Testing

A recent study of women receiving healthcare through federally funded clinics in the southeastern US found that only 8% of women who met Medicare eligibility criteria for BRCA testing actually had genetic testing done. Out of 718 women diagnosed with breast or ovarian cancer, 92 met Medicare criteria — yet only 8 of those women were tested. For about half of the untested women whose records were reviewed, a need for genetics services was documented in fewer than 10% of cases, and in no cases was a referral to genetic counseling documented.

Back to Basics

Despite all the advances in genomics, we're still falling short on the basics: identifying individuals with common single-gene disorders that significantly increase cancer risk and for which meaningful medical management exists. Two of the three disorders identified by the CDC as Public Health Genomics priorities confer increased ovarian cancer risk: Hereditary Breast and Ovarian Cancer (HBOC) and Lynch syndrome. For women at high risk for ovarian cancer related to mutations in BRCA1, BRCA2, Lynch syndrome genes, RAD51C, RAD51D, or BRIP1, the standard recommendation is to remove both ovaries and fallopian tubes, with timing determined by the specific gene and family history.