Why Aren't Enough Low-Income U.S. Women Receiving BRCA Testing?

Genetic testing for BRCA mutations allows identification of patients who may benefit from risk-reducing interventions. From a cohort of >84,000 patients receiving care at federally funded clinics in the southeastern U.S. and enrolled between 2002 and 2009, investigators identified women with breast or ovarian cancer diagnoses and Medicare coverage (eligibility for coverage of BRCA testing was based on family history, while tumor characteristics were based on cancer registry pathology reports).

Among 718 eligible women (62% black; 33% white; mean age at cancer diagnosis, 64 [breast], 62 [ovarian]; 62% low-income), 92 met Medicare criteria for BRCA testing. Of these, 9% were tested during a median follow-up of 5 years. Medical record review fo…