Myriad Genetics has received criticism and protest from oncologists and geneticists for its continuous advertisement of cancer gene testing to the public. The advertisement targets women aged 25 to 55 years with a family history of breast and ovarian cancer. The test, BRACAnalysis identifies mutations in genes, BRCA1 and BRCA2 when present in a sample. Patients with mutations deemed clinically significant have a 35 to 84 percent chance of developing breast cancer by age 70 and it is 10 to 50 percent likely they will develop ovarian cancer. This statistic is far higher than for women in general, in fact 1 in 400 women carry such a mutation. As of today 200,000 patients have taken the BRACAnalysis since it release in 1996. Three percent of the women who have taken this test were found to carry a mutation. This is only slightly higher than the 2 percent of the public a government agency says are good candidates for the gene testing. As a result, the company's marketing motives have come into question and are currently being investigated. In the midst, Myriad Genetics has release an advertisement campaign throughout New York City, encouraging women to inquire of the $3,120 assay.
http://www.nytimes.com/2007/09/11/business/media/11genetics.html?_r=2&oref=slogin&oref=slogin
6 comments:
I don't like this one bit. First, a service like this seems to deter regularly daily checking of lumps and getting screenings. They are basically creating a test that is not necessary - if you have these types of cancer in your family, you obviously have a risk of developing it. You don't need a test to tell you that at this point. Totally pointless , greedy, and manipulative.
I agree with Ben's comment. If there were evidence-based guidelines and clinical studies that supported the use and necessity of this test, I could see the importance of a marketing campaign for consumers. However, a Pubmed search for BRACAnalysis returned 3 results. One trial and 2 publications discussing the implications of direct-to-consumer advertising. In more than 10 years of testing, only one study has been published on this test?
Re: Myriad Genetics breast cancer test service: I find this so interesting. There are tests that are valuable for screening, actually finding disease in a general population; there are tests that are only valuable for a subset of a population, such as some genetic tests, where the false results in a general population make the test less than worthwhile, but in a targeted population become more accurate. Apparently from this article, though, even if the testing is done on a targeted population, the statistics are such that the test’s utility and validity are not certain.
My mom had breast cancer in her 50s. We discussed briefly me having this test done. I believe my physician talked me out of it, though this was well before any questioning of this company. I think the reason was the type of breast cancer Mom had (hopefully not because he didn’t think the insurance would pay for it and therefore cautioned me against having it done).
Ultimately, I’m not sure what I think about this. I think this test might make some women feel better, perhaps falsely, if they test negative for the mutations. It will frighten some women, perhaps without reason, who test positive for the mutation. But if it’s me, don’t I want to have that information?
Do women want this information though, if there is not much they can do in the way of prevention?
The article states, preventative measures include "having their breasts or ovaries removed." The other option is cancer-preventive medications, which the entire population might want access to, if evidently effective and safe. But how many women would go to the measures mastectomies and hysterectomies when there is a chance that, 1. cancer could develop elsewhere or 2. the test results were wrong (ie, false negative, unreliable testing)? --I supposed a case where both conditions exist is possible, but unlikely-- What is the point if there are no reasonable and reliable options for prevention?
Still, the technology is fascinating. And I believe testing such as this is perhaps a step in the right direction toward more effective preventative and therapeutic options for patients.
Against it. Definitely more hard-core evidence needed to justify.
Further to V's post, check out this article:
http://www.nytimes.com/2007/09/16/health/16gene.html
It discusses how women are being tested for BRCA1 and considering mastectomies to beat the cancer before they know for sure it will develop. I think it is an extremely drastic measure, and like Wanda, can only hope the BRCA testing leads to more accurate and precise results.
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