Report: Screen all women over 30 for faulty cancer gene
18 January 2018 National
Researchers at Barts Cancer Institute, supported by the London School of Hygiene and Tropical Medicine compared the costs and health benefits of different strategies for genetic testing.
They found so-called ‘population testing’ prevented many more cases than the current strategy of only screening women with a personal or family history of cancer.
In fact, they say if all women over 30 got tested, it could result in up to 17,000 fewer ovarian cancers, and 64,000 fewer breast cancers in the UK.
Dr Ranjit Manchanda, a consultant gynaecological oncologist at Barts Cancer Institute, told Sky News: "We compared both the costs of the two strategies and the consequences or health benefits of the two strategies and we found that a population based testing strategy outweighs the criteria strategy because you prevent more cancers, and therefore save more lives and it will be cost effective in economics terms.
"With the costs of testing falling, this approach can ensure more women can take preventative action to reduce their risk or undertake regular screening."
It is an approach backed by Alison Dagul, who has been diagnosed with both breast and ovarian cancer and endured years of gruelling chemotherapy. She is a carrier of the faulty BRCA gene mutation, which made it much more likely she would develop the disease – but only found out once she had already had breast surgery. She says she wishes she had known earlier.
She told Sky News: "It would have made a difference.
"I think every week when you’ve got ovarian cancer makes a difference, because it spreads quite rapidly and ovarian cancer is sadly one of the cancers that is pretty fatal. For me, if I could wind back the clock, or had had the knowledge, it would be amazing that I could have had preventative surgery."
Alison’s daughter Gaby has also since been found to be carrying the BRCA gene mutation, and underwent a double mastectomy last year at the age of just 26.
Gynaecological charity the Eve Appeal, which funded the research, says the current strategy, testing only women with a background of cancer, has led to many problems.
"There are lots of complications with that," says chief executive Athena Lamnisos.
"Women aren’t aware of their family history completely, what relatives have died of, and there have been a lot of changes to that but genetic testing is still not widely available even if you have a worry that you are at high risk."
But, she says, if the new strategy was rolled out, it would give women more options.
She said: "It’s a simple blood test, it’s becoming more and more available. And the information that you get is very powerful for you because you can take risk reducing decisions and prevent those cancers from developing."
But if that strategy were to be rolled out, it wouldn’t be without its problems, both practically and morally, cautions Justine Alford of Cancer Research UK.
She told Sky News: "If we’re going around and screening all women who are above the age of 30 for these particular genes, these faulty genes, are we going to pick up women who have these particular genes but might not actually develop a disease as a result of these genes?
"And that could cause a huge amount of anxiety in these women. And what if they go on to make potentially life changing decisions such as risk reducing surgery?"
At present the research, in the Journal of the National Cancer Institute, is only making recommendations. But the researchers hope to use it for the basis of a clinical study which they would eventually like to see rolled out nationwide.