Cascade testing in Italian Hereditary Breast Ovarian Cancer families: a missed opportunity for cancer prevention?

Autor: Trevisan L; Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Godino L; Unit of Medical Genetics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Battistuzzi L; Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Innella G; Unit of Medical Genetics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy., Luppi E; Unit of Medical Genetics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy., Buzzatti G; Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Gismondi V; Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Blondeaux E; U.O. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genova, 16132, Italy. evablondeaux@gmail.com., Bonelli LA; U.O. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genova, 16132, Italy., Turchetti D; Unit of Medical Genetics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy., Varesco L; Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Jazyk: angličtina
Zdroj: Familial cancer [Fam Cancer] 2024 Jun; Vol. 23 (2), pp. 197-207. Date of Electronic Publication: 2023 Nov 16.
DOI: 10.1007/s10689-023-00349-w
Abstrakt: Healthy carriers of BRCA1/2 pathogenic variants (PVs) may benefit from risk-reducing measures of proven efficacy. The main approach to identify these individuals is cascade testing, and strategies to support this complex process are under investigation. In Italy, cascade testing has received little attention; therefore, we analyzed the uptake and characteristics of BRCA1/2 cascade testing in families diagnosed with HBOC between 2017 and 2019 at two Italian genetics centers. All blood relatives aged 18 years or older at September 2022 and who could be involved in the first step of cascade testing (i.e., all the living relatives closest to the proband) were included. In addition to first-degree relatives, individuals who were second-, third- or fourth-degree relatives were included if the closest relative(s) was/were deceased. Overall, 213 families were included (103, Genoa; 110, Bologna). Most probands were women affected by breast and/or ovarian cancer (86.4%, Genoa; 84.5%, Bologna), and the branch segregating the PV was known/suspected in 62% of families (62.1%, Genoa; 60.9%, Bologna). Overall, the uptake of cascade testing was 22.8% (25.8%, Genoa; 19.9%, Bologna; OR = 0.59: 95%CI 0.43-0.82). It was strongly associated with female gender (OR = 3.31, 95%CI 2.38-4.59), age ≤ 70 years (< 30 years OR = 3.48, 95%CI 1.85-6.56; 30-70 years OR = 3.08, 95%CI 2.01-4.71), first-degree relationship with the proband (OR = 16.61, 95%CI 10.50-26.28) and segregation of the PV in both the maternal (OR = 2.54, 95%CI 1.72-3.75) and the paternal branch (OR = 4.62, 95%CI 3.09-6.91). These real-world data may be important to inform the design and implementation of strategies aimed at improving the uptake of HBOC cascade testing in Italy.
(© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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