“Before we get too excited about the possibility of giving everyone access to potentially life-saving information, we need to remember that the relationship between the BRCA genes and cancer incidence is complex and fraught with uncertainty,” writes Shobita Parthasarathy, associate professor of public policy at the Ford School, in “Population screening for BRCA: Is it the way forward for genetic medicine?”
Parthasarathy, the author of Building Genetic Medicine: Breast Care, Technology, and the Comparative Politics of Health Care, is discussing the growing push among prominent scientists to screen women for BRCA gene mutations, which indicate an increased risk for breast and ovarian cancer. Parthasarathy points out that while we know these mutations signal risk, we still have limited understanding about the nature and level of risk, and that prophylactic mastectomy and ovary removal, the most effective medical interventions now available to ameliorate cancer risk, “produce their own physical and psychological side effects.”
“A responsible population BRCA screening program would have to be part of a national health, social, and policy infrastructure that would help citizens contend with these uncertainties and make appropriately informed decisions about their cancer risk to improve their health outcomes,” writes Parthasarathy. “That said, these calls should inspire policymakers, public health officials, and research funding agencies to reconsider our health care and policy infrastructure to handle the expansion of genetic testing. We need more specialists in genetics, and we need to think in political, economic, and technical terms about how to make the explosion of genetic information useful to individual citizens.”
Shobita Parthasarathy is an associate professor of public policy at the University of Michigan’s Gerald R. Ford School of Public Policy. Her research focuses on the governance of emerging science and technology, particularly those that have uncertain environmental, social, ethical, political, and health implications. Parthasarathy also leads the Risk Science Center Risk Governance Focus Initiative.