Who is being tested for BRCA?

April 12, 2017

A study looks at who is being tested for BRCA mutations as testing becomes more common. Also, a look at the impact of Zika virus on birth defects using benchmark data. Plus: How is the United States doing with infant mortality?

In the years following the discovery of the BRCA mutation, testing has become increasingly common. However, women who are at high risk for cancers may be missing out according to a new study in the American Journal of Preventative Medicine.

Researchers looked at data from 53,254 women who had insurance claims for BRCA mutation testing between 2004 and 2014. They looked at trends in the use of BRCA mutation testing in women who were unaffected by breast or ovarian cancer and those who had a previous diagnosis of either disease.

The proportion of women receiving BRCA mutation testing who had no previous diagnosis of breast or ovarian cancer significantly increased from 24.3% in 2004 to 61.5% in 2014 (P < 0.001). Across all subgroup of unaffected women, an increase in BRCA testing was found. By 2014, most of the subgroups had a proportion over 50%, excluding women aged 51 to 65 years and women who had no familial history of breast cancer. In women aged 20 to 40 years, there was a much lower proportion of BRCA testing among those women who had previously been diagnosed with breast or ovarian cancer than in those with no previous diagnosis (17.6% vs 41.7%, P <0.001).

The researchers concluded that while originally thought of as a way of catching breast and ovarian cancer in the very early stages of the diseases among women with a previous history, BRCA mutation testing is used more in women with no previous cancer diagnosis. 

NEXT: CDC highlights benchmark Zika data

 

CDC highlights benchmark Zika data

A new analysis from the Centers for Disease Control and Prevention (CDC) provides benchmark data from 3 states on birth defects prior to the Zika virus outbreak. Published in Morbidity and Mortality Weekly Report, the population-based assessment underscores the relationship between the virus and neural tube defects and other early brain malformations.

Birth defects data statewide in Massachusetts and North Carolina for 2013 and from 3 counties in metropolitan Atlanta, Georgia for 2013 and 2014 formed the basis of the report. Population-based surveillance programs in those locations were chosen because they: (1) looked at all types of birth defects; (2) used active multisource case-finding; and (3) quickly provided individual-level data with sufficient detail to apply all inclusion and exclusion criteria.

Prevalence of birth defects potentially related to congenital Zika virus among the 747 infants and fetuses reflected in the programs from the 3 states in 2013-2014 was 2.86 per 1000 live births (confidence interval [CI] 2.65-3.07) versus 58.8 per 1000 live births to mothers with laboratory evidence of possible infection that were recorded by the US Zika Pregnancy Registry from January 15 to January 22, 2016. During the pre-Zika era, the birth defects most commonly reported by the 3 surveillance programs were brain abnormalities or microcephaly (1.50 per 1000), followed by neural tube defects and other early brain malformations (0.88 per 1000).

The finding of a 20 times higher proportion of one or more of the same birth defects during the Zika epidemic versus prior to its advent, the authors said, demonstrates the importance of population-base surveillance for interpreting data about birth defects potentially related to Zika virus. They concluded that the relationship between congenital Zika virus infection and birth defects is supported by the new epidemiologic data.

NEXT: CDC highlights benchmark Zika data

 

CDC highlights benchmark Zika data

A new analysis from the Centers for Disease Control and Prevention (CDC) provides benchmark data from 3 states on birth defects prior to the Zika virus outbreak. Published in Morbidity and Mortality Weekly Report, the population-based assessment underscores the relationship between the virus and neural tube defects and other early brain malformations.

Birth defects data statewide in Massachusetts and North Carolina for 2013 and from 3 counties in metropolitan Atlanta, Georgia for 2013 and 2014 formed the basis of the report. Population-based surveillance programs in those locations were chosen because they: (1) looked at all types of birth defects; (2) used active multisource case-finding; and (3) quickly provided individual-level data with sufficient detail to apply all inclusion and exclusion criteria.

Prevalence of birth defects potentially related to congenital Zika virus among the 747 infants and fetuses reflected in the programs from the 3 states in 2013-2014 was 2.86 per 1000 live births (confidence interval [CI] 2.65-3.07) versus 58.8 per 1000 live births to mothers with laboratory evidence of possible infection that were recorded by the US Zika Pregnancy Registry from January 15 to January 22, 2016. During the pre-Zika era, the birth defects most commonly reported by the 3 surveillance programs were brain abnormalities or microcephaly (1.50 per 1000), followed by neural tube defects and other early brain malformations (0.88 per 1000).

The finding of a 20 times higher proportion of one or more of the same birth defects during the Zika epidemic versus prior to its advent, the authors said, demonstrates the importance of population-base surveillance for interpreting data about birth defects potentially related to Zika virus. They concluded that the relationship between congenital Zika virus infection and birth defects is supported by the new epidemiologic data.