Willingness of Japanese patients with breast cancer to have genetic testing of BRCA without burden of expenses.

BACKGROUND

Genetic analysis for individuals who are at risk for hereditary breast and ovarian cancer syndrome (HBOC) has becoming widely accepted. The poor introduction of the genetic testing of BRCA in Japan compared with western countries could be due to insufficient recognition of its importance, prejudice against a heredity disease, especially in non-urban districts, and its high cost. There is few available data regarding the acceptance or willingness to have genetic testing among Japanese who are at risk and living outside Tokyo.

METHODS

Of 670 patients seen and detailed family history taken at our hospital, located non-urban, 30 (4 %) gave the family history of breast cancer in more than 2 members within the second degree relatives ("stronger" family history group), 92 (14 %) in 1 member ("weaker" group), and 548 (82 %) in none of members ("sporadic" group). Then, we selected 107 (24 from "stronger", 50 from "weaker", 33 from "sporadic" family history group) to see if they are willing to receive cost-free genetic testing of BRCA 1 and BRCA2.

RESULTS

Ninety-two of 107 (86 %) patients agreed and 15 (14 %) refused. The rate of refusal for BRCA testing was higher in "stronger family history group" (6/24, 25 %) compared to "weaker" (7/50, 14 %) or "sporadic" (2/33, 6 %) (p = 0.04), respectively.

CONCLUSIONS

These data indicate that the currently available preventive measures and/or counseling system may not be sufficient enough to convince the high risk population to receive the genetic testing or to overcome the prejudice in non-urban area in Japan, even if served free.