BRCA testing utilization among commercially insured women with breast or ovarian cancer.

Purpose: This report examines utilization of germline BRCA genetic testing among women with breast or ovarian cancer in the context of current clinical guidelines for testing.

Methods: Linked IQVIA commercial claims and electronic medical record data were used to analyze BRCA test utilization among women aged 18-64 years with newly diagnosed breast cancer or ovarian cancer during 2016-2021, excluding 2018. Log-binomial regression models were used to estimate prevalence ratios (PRs) comparing utilization of testing by cancer type, age group, race, and year.

Results: Among commercially insured women with newly diagnosed breast cancer (n = 19,139) or epithelial ovarian cancer (n = 1639), 50 and 47%, respectively, received germline BRCA testing during the study years. BRCA testing rates were higher among women with breast cancer aged 18-50 years (69%) compared to those aged 51-64 years (39%). Overall utilization among women with breast or ovarian cancer was slightly lower in 2021 compared to 2019 and 2020. Compared with White women with breast cancer, Asian women were less likely (PR, 0.83 [95% CI, 0.74-0.92]) to receive testing.

Conclusion: Nearly one-third of women who had breast cancer at age 50 or younger and a majority of women with ovarian cancer had no germline BRCA testing recorded within 1 year of diagnosis. Under current (2024) guidelines, these women and their family members are eligible for genetic counseling and testing to guide preventive interventions for future cancers. Healthcare providers have an important role in offering genetic services to women and their families, ensuring that eligible women receive recommended care.