The Screen Project


Know if you are at High Risk for Breast,
Ovarian, or Prostate Cancers

A Canada-Wide BRCA Study for Men and Women


→ Join the Study

A BRCA Mutation Can Increase the Lifetime Risk of Breast Cancer in Women from


to Up to

A BRCA Mutation Can Increase the Lifetime Risk of Ovarian Cancer in Women from


to Up to



What is The Screen Project?


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. We invite you to order your BRCA test from your home, from anywhere in Canada. For a cost of $165 USD, Veritas Genetics will ship a saliva collection kit to your home. Once completed, collection kits are sent back to Veritas Genetics and results will be received in 2-4 weeks. Individuals who are unable to afford the cost of the test are eligible for financial assistance.

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.



Why Should You Care?


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:

  • Women with a recent or past history of breast or ovarian cancer
  • Women with ductal carcinoma in situ (DCIS)
  • Men with prostate cancer
  • Men and women with pancreatic cancer
  • Women and men with a family history of breast or ovarian cancer.

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.


What is hereditary cancer?


What is the Screen Project ?

What could genetic testing
mean to you?

What to Expect?

The Need

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 and Veritas Genetics 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:

  • Women with a recent or past history of breast or ovarian cancer
  • Women with ductal carcinoma in situ (DCIS)
  • Men with prostate cancer
  • Men and women with pancreatic cancer
  • Women and men with a family history of breast or ovarian cancer.

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.

Objective

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:

  1. To measure the feasibility of BRCA genetic testing among Canadian men and women using a guided direct-to-consumer approach
  2. To determine the frequency of BRCA1 and BRCA2 mutations in unselected Canadians
  3. To evaluate the level of satisfaction among participants following a guided direct-to-consumer approach for BRCA genetic testing
  4. To measure levels of cancer-worry among participants with a positive or negative genetic test result
  5. To estimate the number of breast and ovarian cancers prevented in Canada through a guided direct-to-consumer approach for BRCA genetic testing

Who We Are

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.

Current Model of Genetic Testing for BRCA1 and BRCA2 Genes

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.

Clinical Gaps in the Current Model

Currently, there are three major clinical gaps in identifying carriers of cancer predisposing BRCA1 and BRCA2 genes. Our goal is to address these gaps:

  1. Given the eligibility criteria set out by the provinces for BRCA genetic testing, access is limited to a small proportion of the population, ie. those with a strong personal or family history of cancer. Some individuals who carry a mutation do not qualify for genetic testing based on current guidelines. Additionally, some individuals who qualify for genetic testing fail to be identified and/or referred for genetic testing by their primary health care provider.
  2. Current hereditary cancer testing is offered to patients too late, with most tests done after a patient has been diagnosed with cancer. Our goal is to use the information to prevent cancer.
  3. In many cases, receiving genetic testing results after cancer diagnosis prevents this information from being used to decide on the best course of treatment and/or surgery.

Population-Based Genetic Testing: A solution for addressing clinical gaps exist in current model

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.

The Screen Project: A population-based BRCA genetic testing in Canada

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.



© Copyright 2017 Women's College Hospital
For more information, contact: thescreenproject@wchospital.ca