BRCA gene testing is on the rise for women who do not meet the referral requirements based on family history, researchers reported in study findings published in the American Journal of Preventive Medicine. At the same time, many high-risk women do not obtain the test and remain unidentified.

About 5%–10% of breast cancer cases and 10%–18% of ovarian cancer cases can be attributed to mutations in the BRCA1 or BRCA2 genes. Identifying women who carry the mutations gives them the opportunity to make decisions about life-saving, prophylactic treatment. Current data suggest that only 30% of symptomatic and 10% of asymptomatic BRCA carriers have been identified.

The study looked at the change in testing from 2004 to 2014. In 2004, about 75% of women who received BRCA testing had a history of cancer, but by 2014, that number dropped to about 40%.

Researchers attributed the increase in testing to widespread direct-to-consumer genetic test marketing, lower out-of-pocket testing costs, the ability for women to self-refer, and the Affordable Care Act mandating coverage for U.S. Preventive Services Task Force–recommended tests, including BRCA testing.

Oncology nurses should understand the risk factors that suggest the need for BRCA testing and refer patients to genetics counseling when required.