Utilization of BRCA testing in older women with breast cancer and/or ovarian cancer in the state of Texas

Ana Rodriguez, Sharon H. Giordano, Catherine D. Cooksley

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Genetic testing for hereditary breast ovarian cancer
(HBOC) susceptibility due to BRCA1 and BRCA2 (BRCA1/2) gene
mutations became commercially available in the US in late 1996.
Medicare began cost coverage in 2000 for some women with existing
breast and/or ovarian cancer to assess treatment and family testing
options. METHODS: We used the Texas Cancer Registry-Linked Medicare Database for this population-based cross-sectional study. We identified
women aged 66 years or older with breast and/or ovarian cancer
diagnosed between 2005 and 2007 and used their Medicare claims
through 2009 to calculate the rate of testing in Texas and the proportion
of women positive for BRCA mutations. We compared our findings
to current literature. RESULTS: We identified 7,744 having at least one of the International Classification of Diseases, Ninth Revision, Clinical Modification
(ICD-9-CM) codes identifying risk factors associated with HBOC.
Of these 7,744 women, 1,594 (20.4%) were tested, with 1,411 having
a documented risk factor and 183 with no documented risk factors.
The percentages of women with breast and ovarian cancer and positive
mutations were 0.18% and 3%, respectively. CONCLUSIONS: The study of older women with breast and/or ovarian cancer who carry the BRCA1/2 mutation is possible when using a single state’s cancer registry-linked claims administrative database. Although the prevalence of this mutation was comparable to published
estimates in a similar population, the number was small and may limit detailed study of treatment and patient outcomes. IMPACT: Studies such as ours may provide useful information for the nurses, geneticists, and genetic counselors involved in genetic counseling, and follow up of women at high risk for mutations and their families.
Original languageEnglish (US)
Pages (from-to)30-36
JournalTexas Public Health Journal
Volume65
Issue number2
StatePublished - 2013

Fingerprint

Ovarian Neoplasms
Breast Neoplasms
Medicare
Mutation
International Classification of Diseases
Registries
Databases
Genetic Counseling
Genetic Testing
Population
Neoplasms
Breast
Cross-Sectional Studies
Nurses
Costs and Cost Analysis

Keywords

  • BRCA
  • Genetic Mutation
  • Breast cancer
  • Ovarian cancer
  • HBOC
  • Hereditary breast ovarian cancer
  • Genetic counseling

Cite this

Utilization of BRCA testing in older women with breast cancer and/or ovarian cancer in the state of Texas. / Rodriguez, Ana; Giordano, Sharon H.; Cooksley, Catherine D.

In: Texas Public Health Journal, Vol. 65, No. 2, 2013, p. 30-36.

Research output: Contribution to journalArticle

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title = "Utilization of BRCA testing in older women with breast cancer and/or ovarian cancer in the state of Texas",
abstract = "BACKGROUND: Genetic testing for hereditary breast ovarian cancer(HBOC) susceptibility due to BRCA1 and BRCA2 (BRCA1/2) genemutations became commercially available in the US in late 1996.Medicare began cost coverage in 2000 for some women with existingbreast and/or ovarian cancer to assess treatment and family testingoptions. METHODS: We used the Texas Cancer Registry-Linked Medicare Database for this population-based cross-sectional study. We identifiedwomen aged 66 years or older with breast and/or ovarian cancerdiagnosed between 2005 and 2007 and used their Medicare claimsthrough 2009 to calculate the rate of testing in Texas and the proportionof women positive for BRCA mutations. We compared our findingsto current literature. RESULTS: We identified 7,744 having at least one of the International Classification of Diseases, Ninth Revision, Clinical Modification(ICD-9-CM) codes identifying risk factors associated with HBOC.Of these 7,744 women, 1,594 (20.4{\%}) were tested, with 1,411 havinga documented risk factor and 183 with no documented risk factors.The percentages of women with breast and ovarian cancer and positivemutations were 0.18{\%} and 3{\%}, respectively. CONCLUSIONS: The study of older women with breast and/or ovarian cancer who carry the BRCA1/2 mutation is possible when using a single state’s cancer registry-linked claims administrative database. Although the prevalence of this mutation was comparable to publishedestimates in a similar population, the number was small and may limit detailed study of treatment and patient outcomes. IMPACT: Studies such as ours may provide useful information for the nurses, geneticists, and genetic counselors involved in genetic counseling, and follow up of women at high risk for mutations and their families.",
keywords = "BRCA, Genetic Mutation, Breast cancer, Ovarian cancer, HBOC, Hereditary breast ovarian cancer, Genetic counseling",
author = "Ana Rodriguez and Giordano, {Sharon H.} and Cooksley, {Catherine D.}",
year = "2013",
language = "English (US)",
volume = "65",
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journal = "Texas Public Health Journal",
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TY - JOUR

T1 - Utilization of BRCA testing in older women with breast cancer and/or ovarian cancer in the state of Texas

AU - Rodriguez, Ana

AU - Giordano, Sharon H.

AU - Cooksley, Catherine D.

PY - 2013

Y1 - 2013

N2 - BACKGROUND: Genetic testing for hereditary breast ovarian cancer(HBOC) susceptibility due to BRCA1 and BRCA2 (BRCA1/2) genemutations became commercially available in the US in late 1996.Medicare began cost coverage in 2000 for some women with existingbreast and/or ovarian cancer to assess treatment and family testingoptions. METHODS: We used the Texas Cancer Registry-Linked Medicare Database for this population-based cross-sectional study. We identifiedwomen aged 66 years or older with breast and/or ovarian cancerdiagnosed between 2005 and 2007 and used their Medicare claimsthrough 2009 to calculate the rate of testing in Texas and the proportionof women positive for BRCA mutations. We compared our findingsto current literature. RESULTS: We identified 7,744 having at least one of the International Classification of Diseases, Ninth Revision, Clinical Modification(ICD-9-CM) codes identifying risk factors associated with HBOC.Of these 7,744 women, 1,594 (20.4%) were tested, with 1,411 havinga documented risk factor and 183 with no documented risk factors.The percentages of women with breast and ovarian cancer and positivemutations were 0.18% and 3%, respectively. CONCLUSIONS: The study of older women with breast and/or ovarian cancer who carry the BRCA1/2 mutation is possible when using a single state’s cancer registry-linked claims administrative database. Although the prevalence of this mutation was comparable to publishedestimates in a similar population, the number was small and may limit detailed study of treatment and patient outcomes. IMPACT: Studies such as ours may provide useful information for the nurses, geneticists, and genetic counselors involved in genetic counseling, and follow up of women at high risk for mutations and their families.

AB - BACKGROUND: Genetic testing for hereditary breast ovarian cancer(HBOC) susceptibility due to BRCA1 and BRCA2 (BRCA1/2) genemutations became commercially available in the US in late 1996.Medicare began cost coverage in 2000 for some women with existingbreast and/or ovarian cancer to assess treatment and family testingoptions. METHODS: We used the Texas Cancer Registry-Linked Medicare Database for this population-based cross-sectional study. We identifiedwomen aged 66 years or older with breast and/or ovarian cancerdiagnosed between 2005 and 2007 and used their Medicare claimsthrough 2009 to calculate the rate of testing in Texas and the proportionof women positive for BRCA mutations. We compared our findingsto current literature. RESULTS: We identified 7,744 having at least one of the International Classification of Diseases, Ninth Revision, Clinical Modification(ICD-9-CM) codes identifying risk factors associated with HBOC.Of these 7,744 women, 1,594 (20.4%) were tested, with 1,411 havinga documented risk factor and 183 with no documented risk factors.The percentages of women with breast and ovarian cancer and positivemutations were 0.18% and 3%, respectively. CONCLUSIONS: The study of older women with breast and/or ovarian cancer who carry the BRCA1/2 mutation is possible when using a single state’s cancer registry-linked claims administrative database. Although the prevalence of this mutation was comparable to publishedestimates in a similar population, the number was small and may limit detailed study of treatment and patient outcomes. IMPACT: Studies such as ours may provide useful information for the nurses, geneticists, and genetic counselors involved in genetic counseling, and follow up of women at high risk for mutations and their families.

KW - BRCA

KW - Genetic Mutation

KW - Breast cancer

KW - Ovarian cancer

KW - HBOC

KW - Hereditary breast ovarian cancer

KW - Genetic counseling

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VL - 65

SP - 30

EP - 36

JO - Texas Public Health Journal

JF - Texas Public Health Journal

IS - 2

ER -