USPSTF Updates Its Recommendations on Genetic Testing for BRCA-Related Cancers

By Nicole Choy · Aug 2019

The US Preventive Services Task Force (USPSTF) released updated recommendations on risk assessment, genetic counseling, and genetic testing for BRCA-related cancers, updating their previous recommendations from 2014. The updated recommendations were based on a review of over 100 studies.

The Two Recommendations

The USPSTF recommends (Grade B) that women with a personal or family history associated with increased risk for harmful BRCA mutations should receive risk assessment through routine medical practice, and if the assessment suggests increased risk, genetic counseling and consideration of genetic testing. Women without a relevant personal or family history, however, should not receive routine risk assessment or testing (Grade D — harms outweigh benefits or there is no net benefit).

What These Recommendations Don't Cover

These recommendations are more conservative than those of other organizations. The American Society of Breast Surgeons recommends genetic testing for all women with a personal diagnosis of breast cancer. NCCN guidelines recommend counseling and consideration of testing for men with aggressive prostate cancer and for individuals with a personal or family history of pancreatic cancer. The USPSTF recommendations also don't address the risk for men to carry BRCA mutations, despite the fact that men and women are equally likely to carry them.

If you have questions about your personal or family history, or are wondering whether you might be a good candidate for testing, a genetic counselor can help you understand your options — regardless of which set of guidelines applies to your situation.