Wednesday, January 16, 2008

Would you want to know? Testing your children for the breast cancer gene (BRCA)


*At right is a computer model of the BRCA-1 gene protein

The American Journal of Medical Genetics published a provocative paper this month titled, "Should genetic testing for BRCA1/2 be permitted for minors?" and reflected the surveyed opinions of adult carriers of the most defined "breast cancer gene" mutations, BRCA-1 & BRCA-2, about their feelings on having their children screened in adolescence.

What was the result?
A strong majority felt they'd support more aggressive screening. No surprise there.

What's the controversy?
Is it right to burden teenagers with genetic information that they may not be able to properly understand or cope with. This topic of "genetic destiny" also predictably brings with it discussion of practical issues (Will I be discriminated against for getting a job or health insurance?) as well as discussion of ridiculous parallels (ie. Nazi eugenics).

I personally find the logic of not screening to be flawed. Carriers of the gene are predisposed to not only breast cancer, but also to ovarian, colon, prostate, and uterine malignancy among others. More aggressive screening tests and liberal use of prophylactic mastectomy would actually make a dramatic difference in cancer-specific mortality in this subset of the population.

Something to think about!

Rob

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