Health
NHS rolls out national gene testing to spot cancer risk in Jewish community
Jewish people in England are being invited to take part in a national gene testing programme so that their higher likelihood of having a faulty BRCA gene is spotted early.
NHS England is rolling out a national testing programme for BRCA—the two genes BRCA1 and BRCA2, which repair DNA damage and normally help to protect against cancer.
People of Jewish descent are six times more likely to have a fault in the BRCA gene than the general population, leaving them at higher risk of certain cancers, including breast, ovarian, prostate, and pancreatic cancer.
The new national NHS Jewish BRCA testing programme, which is not a full national screening programme, will invite anyone over the age of 18 with Jewish ancestry to take a genetic saliva test that will look for the presence of BRCA1 or BRCA2 faults. Saliva samples will be carried out at home before being sent to laboratories for testing.
A pilot of the programme has been in operation since February 2023 during which time NHS England said thousands of people had come forward for testing. It hoped that the national rollout would see around 30 000 further people tested over the next two years. Work done during the pilot phase showed that of 5000 people tested, around 80 (2.6%) were found to have an altered BRCA gene.
Everyone identified as having a BRCA gene fault is to be offered a phone appointment with a genetic counselling helpline and referral to a local clinical genetics service to explore how to manage their risk.
Although an altered BRCA gene does not automatically mean someone will develop cancer, being aware of their significantly increased risk allows them to receive support from the NHS, said NHS England, and to consider options including regular screening, lifestyle changes, risk reducing surgery, or drugs to help lower risk.
Peter Johnson, national clinical director for cancer at NHS England, said, “BRCA testing for the people most at risk has the potential to save lives, by allowing them to take steps to reduce the chance of cancers developing or making sure that any cancer can be detected as early as possible, with those at increased risk able to take advantage of surveillance and prevention programmes with their health teams.”
Ranjit Manchanda, professor of gynaecological oncology at the Wolfson Institute of Population Health at the Queen Mary University of London and consultant gynaecological oncologist at Barts Health NHS Trust, London, has carried out numerous related studies in recent years. One study found that more than half of people with a BRCA gene fault ware ineligible for testing through a system that used family history based criteria and only 11% of people with a BRCA gene fault in the Jewish community were aware of their status.
Manchanda believes the NHS has the capacity to help people who are found to have the faulty gene and told The BMJ, “We do have capacity and the NHS England team is working closely with downstream stakeholders. It’s only a small proportion of people who are going to be diagnosed who carry the faulty BRCA gene.”
The charities Jnetics and Chai Cancer Care have been running an engagement campaign to help raise awareness in Jewish communities.
Jnetics chief executive Nicole Gordon said, “The initial pilot phase has proven to be a huge success and we are now able to roll this out more broadly and offer the Jewish community a huge opportunity to gain the knowledge that will help mitigate the impact of hereditary cancer and ultimately save lives.”
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