# Health Care Equity and BRCA1/2 Testing

## TL;DR

This paper discusses disparities in BRCA1/2 testing for breast cancer patients and suggests expanding testing and implementing initiatives to improve equity.

## Contribution

The paper highlights disparities in BRCA1/2 testing and proposes expanding testing and the Cancer Moonshot 2.0 Initiative to address them.

## Key findings

- There are significant disparities in who receives BRCA1/2 testing after a breast cancer diagnosis.
- Expanding testing to all breast cancer patients could help reduce these disparities.
- The Cancer Moonshot 2.0 Initiative is suggested as a way to mitigate these inequities.

## Abstract

Although most cancers are sporadic, a significant proportion are related to inherited cancer-causing genes called pathogenic germline variants (PGVs). There are recommended measures for prevention and earlier diagnosis of cancers in patients identified as BRCA1 and BRCA2 PGV carriers, which are the most common cancer-predisposing PGVs. For example, published guidelines recommend that patients with BRCA1/2 PGVs undergo bilateral oophorectomies to prevent ovarian cancer and regular magnetic resonance imaging to screen for breast cancer. Also, those same measures are recommended for family members identified by cascade testing as BRCA1/2 carriers. Here, reports of the significant disparities between groups in which patients diagnosed with breast cancer are offered and undergo testing for BRCA1/2 PGVs are reviewed. Expanding the current standard of care guidelines for BRCA1/2 testing to all patients diagnosed with breast cancer and enacting the Cancer Moonshot 2.0 Initiative measures that should mitigate these disparities are discussed as well.