The Screen Project is a Canadian National initiative to make BRCA1 & BRCA2 screening available to all Canadians over 18 years of age at an accessible price. As part of The Screen Project, you will also help our team of researchers at the Familial Breast Cancer Research Unit of Women's College Hospital evaluate the benefits of population-based genetic testing. We hope that our study will reduce the mortality from breast, ovarian, prostate and other cancers.
We are not enrolling new participants in the study at this time. Please check back for updates on when you can participate in the study.
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Breast cancer is the most common cancer among Canadian women and affects approximately 1 in 9 women and ovarian cancer affects another 1%. In men, prostate cancer will affect about 1 in 8 men. We do not understand the cause of most cancers, but approximately 5-10% of all breast and ovarian cancers are hereditary and due to a mutation in a gene that is passed down from one generation to the next.
Two genes, BRCA1 and BRCA2, are strongly associated with breast, ovarian and prostate cancers. BRCA mutations predispose women to a higher lifetime risk of breast and ovarian cancer. Men with a BRCA mutation are at increased risk of developing prostate and other cancers. It is estimated that one in every 200 Canadians carries a mutation in one of the two BRCA genes. However, members of several groups are more likely to have a mutation than the average Canadian. These groups include:
Knowing if you have a BRCA mutation can help us detect cancer earlier in you and your family members, and in many cases cancer can be prevented.
Currently, genetic testing for BRCA1 and BRCA2 is provided through provincial programs to women and men who meet eligibility criteria. This means that testing for BRCA in Canada is only available to a small number of men and women with a strong personal or family history of cancer. Our goal at Women's College Hospital is to make genetic testing for cancer available to all men and women in Canada at an accessible price.
It is estimated that one in every 200 individuals in the general population carry a mutation in one of the BRCA genes. However, there are several groups who are more likely to have a mutation than the average Canadian. These include:
Through The Screen Project, we’re offering BRCA genetic testing to those who are not currently eligible for a provincially-covered test. Many women and men who have recently been diagnosed with cancer will wish to receive the genetic test result quickly in order to help them decide on the best treatment.
Genetic testing for cancer predisposition is now a standard component of clinical practice in oncology. Inherited mutations in BRCA1 and BRCA2 are responsible for 5-10% of all breast cancers and 10-15% of all ovarian cancer cases. BRCA mutations predispose women to a higher lifetime risk of breast and ovarian cancer. Men with a BRCA mutation are at increased risk of developing prostate cancer. Several preventive options are now available to reduce cancer risks and mortality, including intensified screening and prophylactic surgery. Additionally, women and men with cancer may benefit from treatments tailored to their genetic makeup. Our main objective is to establish a Canada-wide population-based genetic testing model for BRCA genes in order to identify as many as possible of mutation carriers with an ultimate goal of reducing cancer morbidity and mortality from breast, ovarian, prostate and other cancers. For achieving that goal, The Screen Project has been designed with these five specific objectives in mind:
We are group of researchers, consisting of Drs. Steven Narod, Mohammad Akbari, Joanne Kotsopoulos and Kelly Metcalfe. Nicole Gojska is the project's genetic counselor. We are based at Familial Breast Cancer Research Unit, Women’s College Research Institute (WCRI), Women’s College Hospital (WCH), University of Toronto. We are bringing population-based genetic testing for BRCA genes to Canadians at an affordable price. This will provide us the opportunity of evaluating the benefits of such a testing model in a large scale.
The Familial Breast Cancer Research Unit was established at Women’s College Hospital in 1995 and includes four core scientists, their trainees, and 30 support staff – all of whom are located at Women’s College Research Institute (WCRI). The team is led by Dr. Steven Narod and considered by many to be the world’s leading research team on management of hereditary breast cancer. The team has an international track record and many contributions to the field of hereditary breast and ovarian cancer. These scientific contributions have resulted in a better understanding of the implications of genetic susceptibility to cancer and have led to better outcomes among high-risk individuals. The team collaborates with scientists at 64 centres worldwide and has published more than 600 papers in the past 15 years.
Currently genetic testing for BRCA1 and BRCA2 is offered through provincial programs, such as the Ontario Ministry of Health and Long Term Care for Ontario. For individuals interested in genetic testing, criteria must be met in order to qualify for testing, including age at cancer diagnosis, ethnicity, and family history of breast or ovarian cancer. Typically, a patient is provided in-person genetic counseling at a local cancer genetics clinic prior to BRCA testing.
Currently, there are three major clinical gaps in identifying carriers of cancer predisposing BRCA1 and BRCA2 genes. Our goal is to address these gaps:
A long-term solution for addressing all of the clinical gaps outlined under the Current Model Tab is to have a national population-based genetic testing approach for hereditary cancers. This approach uses genetic testing as a screening tool to identify high-risk patients, followed by genetic counselling to review and discuss the screening and prevention options available for those identified as high-risk. Genetic counseling resources would be directed toward the mutation-carriers who need it the most. The two other main advantages of this model for genetic testing are that we can identify a larger proportion of mutation-carriers in the population (i.e. higher sensitivity) and more importantly, identify mutation-carriers before they develop cancer so that they can be offered preventive measures.
Overall, a population-based approach gives all men and women the option of learning their BRCA mutation status and to make informed decisions about their health. No studies have evaluated the cancer risks for mutation-carriers ascertained from the general Canadian population (patients unselected for their personal or family history of cancer). Therefore, before making recommendations for a nation-wide BRCA screening approach, it is important to assess the outcomes and level of interest in genetic testing among Canadians, and to determine the level of satisfaction among participants. To do this, we have designed a prospective study named The Screen Project that will evaluate population-based genetic testing for BRCA mutations in Canada. It is hoped that our research study may lead to accessible genetic testing for breast, ovarian, prostate and other cancers in Canada.
The Screen Project is an initiative of Women’s College Hospital (WCH). To donate in support of women’s cancers research, care and education at WCH, please click here.