The Prevent Ovarian Cancer program at the Princess Margaret Cancer Centre in Toronto is offering some women free testing for the hereditary genes that increase their chances of developing ovarian cancer, with the goal of doing a better job of identifying those who are at risk of the disease.
These gene mutations, BRCA1 and BRCA2, are more common in Ashkenazic women. According to the program’s patient information sheet, carrying either one of them can mean that a woman has up to a 40 per cent risk of being diagnosed with ovarian cancer in her lifetime.
Dr. Alicia Tone, the scientific manager of the program, said that while the frequency of BRCA mutations is between one in 300 and one in 800 in the general population, in Ashkenazic Jews, that number is estimated to be one in 40.
The frequency is “a lot higher,” she said, “so they are a generally at-risk population, but we just have to test them to know whether an individual person or family is at risk.”
One of the reasons for the program is that many women who die of ovarian cancer were never tested for the genes, which means that their close relatives do not qualify for genetic testing through the Ontario Ministry of Health, Tone said.
This makes it difficult for relatives to know whether or not they carry an increased risk. The program hopes to offer these women the chance to be tested, as well as the information needed to prevent the disease in the future.
To qualify, women must be Ontario residents over 18 years of age who have not previously been tested and have a first-degree relative (either a mother, sister or daughter) who died of ovarian cancer – specifically high-grade serous ovarian cancer – without being tested for the genes.
Participants should also have access to the pathology report for their relative. They will be asked to complete a family history questionnaire, provide a blood sample for genetic testing, complete psychosocial questionnaires and participate in pre- and post-genetic counselling.
The goal of the program is to prevent ovarian cancer in high-risk women and to further research into preventing the disease. The program hopes to identify new high-risk genes for ovarian cancer, to learn about the psychosocial impact of genetic testing and to find new ways of genetic counselling that will change the face of cancer care in the future.
Ovarian cancer – which remains the fifth-leading cause of cancer-related deaths in Canadian women – is difficult to screen for early, since its common symptoms are so non-specific: things like bloating, discomfort in the pelvic area and frequent urination. Women known to be at high risk for the disease can undergo surgery that prevents its future development.