Commercials for Myriad BRACAnalysis Genetic Test Under Scrutiny

Commercials for Myriad BRACAnalysis Genetic Test Under Scrutiny

by Dr. Hsien-Hsien Lei
Posted September 11, 2007 in DNA Testing

bracanalysisMyriad Genetics is coming up against criticism for their new advertising campaign promoting the BRACAnalysis direct-to-consumer genetic test for breast and ovarian cancer genes: BRCA1 and BRCA2. The ads are set to run this week in New York, Hartford, Boston and Providence, R.I. Some experts are worried that consumers will be unnecessarily alarmed and that BRCA testing isn’t meant for general population screening, especially because only 10% of women with breast or ovarian cancer are believed to have inherited genetic risk factors. Connecticut attorney general, Richard Blumenthal, has already begun an investigation into Myriad’s claims for the test to assess fairness and accurate representation.

Back in March 2004, the National Human Genome Research Institute (NHGRI) ran a workshop scrutinizing direct to consumer advertising of genetic tests with extensive discussion of Myriad’s marketing of BRACAnalysis. Myriad’s pilot advertising trials five years ago showed that commercials increased public interest and sales of the genetic test. At that time it was determined that both consumers and physicians needed more information about the genetics of breast cancer and the utility of the test. Also, despite greater interest in the test, there were not enough appointments available for patients to see a genetic counselor. The average wait to see a genetic counselor at Kaiser was 8 months and 50% of those who were approved for a risk assessment never received a BRCA test.

Clearly, the situation is different today. Companies like the one I work for, DNA Direct, now offer BRCA testing directly to consumers via our website with access to and support from certified genetic counselors. At-risk individuals who decide they need a BRCA test after researching the extensive information on the DNA Direct website can order a test without the wait. And in many cases, their insurance companies will still cover it. Of course, going the direct-to-consumer route also means you can choose not to disclose your BRCA status to your insurance company if you don’t want to.

Here are some of the recommendations that resulted from the NHGRI direct-to-consumer genetic tests and advertising workshop:

  • How to better convey accurate information to the public, including expected benefits and potential harms of learning genetic information; what to expect from the process itself; criteria or points to address through advertisements.
  • What messages within the advertisements are remembered/understood by consumers? By providers?
  • Are appropriate candidates for the genetic test responding to these messages?
  • What information are consumers looking for from DTC ads in general? Is this different in the realm of genetics?
  • Are there significant distinctions between the advertising practices and the impact of ads for genetic vs. non-genetic diagnostic tests?

breast cancer cellsDr. Gregory C. Critchfield, president of Myriad’s genetic testing business, said in the New York Times:

What we are doing is raising public awareness so they will have a conversation with their health care providers. Those individuals, if they are tested and identified, can avail themselves of means to reduce the risk of cancer.

I know I’m not the only person who thinks that advertising isn’t always evil. Advertising serves to bring new products to our attention and to stimulate interest as well as the desire for more information. In the case of genetics and genetic testing, I would venture to say that all of us need to learn more, not less. And I doubt that most people are so easily persuaded by ads nowadays given our culture of total commercial saturation.

For me, knowing that there are options out there is a good thing. I may not be signing up for genetic testing now, but I still want to be prepared for the future. Hopefully, advertising campaigns that bring genetics into the public eye will prepare more people for the genome revolution that is upon us.

Update: For more on BRCA genetic testing, please see these earlier posts at Eye on DNA.

HT: Genome Technology Daily Scan
Photo: Human breast cancer cells dividing from Wellcome Images under Creative Commons.

Tags: , , , , , , ovarian cancer, , , , , genetic testing, dna tests

(16 comments)


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16 Comments

Comment by NA Subscribed to comments via email

Quote: “Some experts are worried that consumers will be unnecessarily alarmed and that BRCA testing isn’t meant for general population screening, especially because only 10% of women with breast or ovarian cancer are believed to have inherited genetic risk factors.”

What is wrong with advertising a BRCA test for diagnostic purposes? If insurance or a person is willing to pay for the test, does the person have the right to have the test done if they want it done (even without an increased inheritance risk)?

Should the test be limited to about 10 percent of the population? I would say no!

Comment by Hsien

NA, The reason the experts want to limit the test to high risk individuals is because of the chances that a test result may be a false positive or false negative. Even a close to perfectly accurate and reliable screening test will result in false positives and negatives when used in a large enough population.

 
 
Comment by ramunas Subscribed to comments via email

I wonder whether Myriad does test for genomic rearrangements in BRCA genes, like large scale deletions/duplications with MLPA or QMPSF? I can not find this information on their site.

Comment by Hsien

Dr. Ramunas, I believe the comprehensive BRACAnalysis test does detect five genomic rearrangements of the BRCA1 gene. This technical specifications sheet (pdf) from Myriad has more info.

 
 
Comment by Callooh Subscribed to comments via email

I agree that advertising a diagnostic tool is not inherently evil. Also, the concerns here don’t seem all that different from those the pharmaceutical industry grapples with – you need to describe to consumers the context in which the treatment may help and the possible consequences of relying on it.

Comment by Hsien

Totally agreed, Callooh! Goodness knows there’s enough direct-to-consumer advertising all around us from the “evil” big pharmas. ;)

 
 
Comment by NA Subscribed to comments via email

Thank you for the explanation.

Comment by Hsien

Anytime, NA! If you get the chance, I think you would enjoy learning about screening tests and epidemiology: sensitivity, specificity, positive predictive value, negative predictive value. Epi 101 is one of the best classes I’ve ever taken!

 
 

[...] past week we saw the unveiling of a controversial general advertising campaign for the Myriad BRACAnalysis genetic test for breast and ovarian cancer susceptibility. One oft-quoted statistic in relation to the test [...]

 

[...] medical genetic testing, such as Navigenics, DNA Direct, and Myriad (see previous post about advertising for the BRACAnalysis genetic test), must also think about how to appropriately market their services and convince consumers that [...]

 
Comment by Ellen Matloff Subscribed to comments via email

The reason many experts in the field oppose this particular advertising campaign is that the company is calling it a ‘Public Awareness Campaign’ with the stated goal of ’saving lives’, instead of calling it what it is: an aggressive advertising campaign by the company that holds an exclusive patent on BRCA1 and BRCA2 testing, and therefore has a financial interest in selling test kits and raising their stock value. These ads are not subject to the same level of federal regulation as are advertisements for prescription drugs; this is evident based on the content of the ads and the misleading and deceptive claims within. For more information please visit:
responsiblegenetictesting.org

Thanks for stopping by, Ellen. I’m in the UK so I haven’t seen the ads but I know for sure they wouldn’t be allowed here.

 
 
Pingback by Flood of DNA

[...] genetics and genomics over the past few months: new genes, new genetic tests, the controversy over Myriad’s ads for BRACAnalysis, DNA/gene chips, whole genome sequencing, and phamacogenomics. Despite the excitement, not everyone [...]

 

[...] Direct to consumer advertising (or not) [...]

 

[...] much can be explored. The general gist of the genetic testing videos is negative with a focus on Myriad’s BRACAnalysis genetic test for breast and ovarian cancer risk. Of course, it’s safer to recommend we all stay away from [...]

 
Comment by tanzee Subscribed to comments via email

Hello,
Is it true if a woman is tested for the cancer gene that all females in her immediate family will have the gene.

My mother had breast cancer which matastasized to bone cancer which resulted in her death. My sister had breast cancer at 44 and had a mastectomy. I received a pathology report (from breast tissue that was removed due to a bilateral breast reduction which stated that my right breast showed Atypical Lobular Hyperplasia. I understand I do not currently have active cancer, but that I am at a higher risk, especially considering my family history.

I would appreciate any info you can provide regarding my question.

Thanks and God Bless,
Tanzee

 

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