Thursday, February 20, 2020

New York–Metro area Ashkenazi Jewish women and men aged 25 and older can now opt to undergo testing for the three common Ashkenazi Jewish BRCA founder mutations at a fraction of the commercial price, thanks to a new, philanthropy-based initiative from the Program for Jewish Genetic Health (PJGH), a not-for-profit organization affiliated with Yeshiva University and Albert Einstein College of Medicine, in conjunction with Montefiore Health System. This initiative, the first of its kind in the United States, makes this testing available to all Ashkenazi Jewish individuals, regardless of their BRCA-related cancer histories or their insurance/financial situations, both of which have been barriers to date.

Approximately 1 in 40 individuals of Ashkenazi Jewish descent carries one of three founder mutations in the BRCA1 or BRCA2 genes, a carrier rate tenfold higher than that of the general population. Females carrying a BRCA mutation face a significantly higher risk of developing breast and ovarian cancer in their lifetime, while male BRCA mutation carriers are at higher risk of developing prostate and breast cancer, among other cancers. BRCA carriers also have a 50 percent chance of passing the altered gene on to each of their offspring, who in turn will have an increased susceptibility for these cancer types. Individuals who find out that they are BRCA carriers through genetic testing have cancer risk-reducing and reproductive options.

Today, most health insurance policies cover BRCA testing only for those who are considered at “high risk” to have a BRCA mutation—those with a significant personal or family history of these cancers. However, individuals who are at “low risk” to have a BRCA mutation—those who do not have a significant personal or family history of cancer—along with those with no health insurance, are faced with steep out-of-pocket costs. Testing for the three common Ashkenazi Jewish BRCA founder mutations via the traditional, commercial-based process can cost more than $600 for these low risk and uninsured individuals. The Program for Jewish Genetic Health is now providing testing for $100, along with complimentary pre-test genetic counseling courtesy of Montefiore.

According to the PJGH, one of the primary goals of the new initiative, which also includes a research component, is to identify new BRCA mutation carriers in this “low-risk” group who otherwise would have gone undetected. Recent studies from Israel have reaffirmed that the 1 in 40 carrier rate in Ashkenazi Jews also applies to these low risk individuals, and suggest that the risks to develop cancer in BRCA carriers coming from both “low risk” and “high risk” families may be more equivalent than originally thought.

Interested participants aged 25 and older who self-identify as Ashkenazi Jewish will begin by visiting the PJGH’s BRCAcommunity Study website (http://brcacommunitystudy.einstein.yu.edu/), where they can learn more about BRCA and the initiative, and then be directed to complete a detailed demographic form and personal/family history questionnaire.

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