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.
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 email@example.com.
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].
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
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.