Current Status of the Management of Hereditary Breast and Ovarian Cancer in Asia: First Report by the Asian BRCA Consortium

Abstract

Background:BRCA1/BRCA2 mutations are associated with an increased lifetime risk for hereditary breast and ovarian cancer (HBOC). Compared with the Western developed countries, genetic testing and risk assessment for HBOC in Asia are less available, thus prohibiting the appropriate surveillance, clinical strategies and cancer management. Methods: The current status of HBOC management in 14 Asian countries, including genetic counselling/testing uptakes and clinical management options, was reviewed. We analysed how economic factors, healthcare and legal frameworks, and cultural issues affect the genetic service availability in Asia. Results: In 2012, only an estimated 4,000 breast cancer cases from 14 Asian countries have benefited from genetic services. Genetic testing costs and the absence of their adoption into national healthcare systems are the main economic barriers for approaching genetic services. Training programmes, regional accredited laboratories and healthcare professionals are not readily available in most of the studied countries. A lack of legal frameworks against genetic discrimination and a lack of public awareness of cancer risk assessment also provide challenges to HBOC management in Asia. Conclusions: The Asian BRCA Consortium reports the current disparities in genetic services for HBOC in Asia and urges the policy makers, healthcare sectors and researchers to address the limitations in HBOC management.

Genetic and clinical characteristics in Japanese hereditary breast and ovarian cancer: first report after establishment of HBOC registration system in Japan

“…No. 1, 16, 33, 50, and 51 are essential registration items for registrees within the second relatives of the subject or uncles, who suffered from any cancers and registered by interview-based information (they are defined as the Others in Table 2) a The date is deleted at submission (only month and year are registered) for protection of individual information b We can register up to the third breast cancer, if patients had suffered from it c We can register up to the third regimen, if patients had received one Asian BRCA consortium about BRCA1/2 have already been established [1,2]. However, data from Japanese HBOC families are poorly represented in these international databases or collaborative studies.…”

A Matched Case-Control Study of Risk Factors for Breast Cancer Risk in Vietnam

“…Very few women from either group were able to report a family history of cancer (data not shown). This may be for social and/or cultural reasons, which have been suggested as a cause of underreporting of cancer family histories in other Asian studies including our previous study on family history and BRCA 1 and 2 mutations in Vietnam [27, 28]. …”

A Review of the Epidemiology of Breast Cancer in Asia: Focus on Risk Factors

“…In 2016, the Asian BRCA consortium released its first paper on the management of hereditary breast and ovarian cancer (HBOC) in 14 Asian nations. This paper highlighted the disparity in the management of HBOC screening (only approximately 4,000 cases of BC in Asia had benefited from genetic services) between nations and recommended that policy makers, healthcare sectors and researchers address the limitations in HBOC testing and management (Nakamura et al, 2016). Results of the studies included in this review which considered the role of BRCA mutation in BC risk indicated that women with BC and a BRCA1 mutation had an earlier age of disease onset, higher nuclear grade of BC, and a younger age of hospitalization (Chen et al, 2013a;Liu et al, 2013b;Pei et al, 2014;Sun et al, 2014a;Fu et al, 2015;Haryono et al, 2015;Wu et al, 2015) when compared to those without the BRCA mutation.…”