In October 2020, the Sarnoff Center presented our first virtual iteration of What’s Jewish about Hereditary Cancer? Our panelists included genetic counselor Taya Fallen from Insight Medical Genetics, social worker Rebecca Koren from Sharsheret, and specialist in gynecologic oncology, Dr. Shari Snow from UChicago Medicine. After our panelists’ presentations, our moderator, Executive Director of the Jewish Women’s Foundation, Ellen Carmell, moderated a question-and-answer session taking questions from our 120-person audience.
Our panelists answered questions about hereditary cancer genes more prevalent in the Jewish community and about cancer genetic testing, which can help identify a person’s risk of having cancer. One in 40 Ashkenazi Jews carries a disease-causing mutation in the BRCA gene, increasing a person’s risk of developing breast cancer (like its namesake), ovarian cancer, prostate cancer, pancreatic cancer, and certain types of skin cancer.
A select number of questions and answers from our panel of experts are transcribed below. This conversation has been edited for length and clarity. To see the full What’s Jewish about Hereditary Cancer? question-and-answer session video, click here. If you would like to see the recordings of our panelist’s presentations or speak with the Sarnoff Center’s genetic counselor, email us at firstname.lastname@example.org.
Ellen B. Carmell: So much has changed since COVID-19. How are genetic testing and screening protocols being handled during the pandemic?
Taya Fallen: [During the pandemic], genetic counseling can still be provided in [multiple] settings. Consultations can be conducted via phone, Zoom, Microsoft TEAMS, and Google Meet. If a patient would like to be tested, we can send a saliva collection kit to their home. DNA from the saliva is suitable for hereditary cancer testing. For [patients] that do end up testing positive [for a genetic mutation], many medical centers are now opening their doors and having an in-person appointments to help patients with routine surveillance. Having a known gene mutation does not mean sitting at home with that information and not being able to [take actionable steps].
Dr. Shari Snow: Many physicians are also offering virtual visits [at this time]. As Taya mentioned, [physicians] are still doing routine screening services like mammograms colonoscopies for patients with a normal or increased risk [of cancer]. It is important not to significantly delay [your] usual health maintenance and screenings during this time. We do not want to let something get out of hand.
EC: Does insurance cover BRCA testing, and how much does it cost?
TF: “[The cost of] testing of the BRCA genes [is variable, in part based on] if we target the common Jewish mutations [or] if we end up doing the full sequencing and rearrangement testing of the gene. The good news is that insurance companies have comprehensive guidelines and criteria if an individual’s personal or family history suggests having a heritable risk of cancer, such as having Ashkenazi Jewish ancestry. Unfortunately, most of the cost concerns regarding testing of BRCA or other genes [associated with cancer risk] are often related to whether our deductible has been met and what our financial responsibility might be on that end.
SS: The United States Preventative Services Taskforce (USPSTF) classified BRCA [genetic] testing in the same category as mammograms, meaning that testing is considered appropriate preventative care. If patients meet [the USPSTF] criteria, many insurance companies will cover [the cost of testing]; it will not apply to [a patient’s] deductible or copay. [Insurance companies] will cover it the same way they cover a mammogram, which does not require a copay or deductible. Check with your particular plan and policy to make sure you know ahead of time [what they will] cover and what your financial responsibility might be.
You can learn more hereditary cancers and cancer genes that are more prevalent among people of Ashkenazi Jewish ancestry here. If you have additional questions about cancer genetic testing, please contact the Sarnoff Center at (312) 357-4718 or JewishGenetics@juf.org and ask to speak to our genetic counselor.