Congratulations to Dr. Lesa Dawson and team for their recent success in Genome British Columbia’s Societal Issues Grant Competition. In this competition intake, Genome BC was supporting qualitative research to increase equitable access to and adoption of genomic technologies in healthcare.
This two-year project will assess public and community partner preferences for a population-based testing model in BC, followed by a pilot program shaped by these insights to inform a future province-wide strategy. Co-Principal Invesitgator: Dr. Gillian Hanley. Collaborators: Dr. Kasmintan Schrader, Dr. Janice Kwon, Dr. Gavin Stuart, Dr. Stuart Peacock, Mr. Adam Kahnamelli.
Project summary:
Individuals with inherited cancer predisposition (i.e., BRCA genes) have elevated cancer risk. For instance, a healthy young female with a BRCA1 has a lifetime risk of 75% for breast cancer and 44% for ovarian cancer, substantially higher than the general population’s respective risks of 12% and 1.3%. With access to recommended screening and preventive measures, cancer risk can be dramatically reduced and overall survival rate improving by up to 70%.
Although ~1% of the population have this hereditary cancer risk, more than 95% of individuals remain unidentified because they have not had access to genetic testing. In Canada (as in many other countries), federally funded genetic testing programs are limited to individuals with a personal or family history of cancer. This narrow eligibility means most carriers are never tested, resulting in preventable cancer diagnoses and amplifying health inequities.
Population-based testing, a model that offers genetic testing to all individuals regardless of family history, could address these gaps. Recent Canadian modeling shows that PBT could prevent over 3,000 breast and ovarian cancers per million women and is highly cost-effective. However, public support and feasibility must be assessed before implementation.
This project will proceed in two phases. First, we will evaluate public and community partner preferences on how a population-based testing program should be designed, through public focus groups and interviews with healthcare providers, health system leaders, and known-BRCA carriers. Second, we will conduct a pilot feasibility study to trial the program in a small sample, assessing acceptability, satisfaction, and preferences for both pre-test counselling and result disclosure. Together, these findings will inform the development of an effective population-based testing strategy for BC.