Breast cancer is one of the most commonly diagnosed cancers and the second leading cause of cancer death in women, both in Michigan and nationally. Breast and ovarian cancer can run in families and be caused by an underlying genetic change passed from parent to child.
The Michigan Department of Community Health (MDCH) is aiming to increase public awareness of hereditary cancers and encourages Michigan health plans to have written policies consistent with national guidelines. For instance, the U.S. Preventive Services Task Force recommends that women whose family history is associated with an increased risk for a change in the BRCA1 or BRCA2 gene, should be referred for genetic counseling and evaluation for testing. By working with Michigan health plans as well as the Michigan Association of Health Plans, the MDCH Cancer Genomics Program is striving to ensure that BRCA positive women have access to the life-saving screenings and interventions they need.
Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) are two plans that received MDCH’s award in 2010 for Cancer Genomics Best Practices, and again in 2013 for their policies on clinical services related to the care of BRCA positive women. Such services include mammography screening, breast MRI, and the option of surgery to remove breast or ovarian tissue before cancer occurs. According to the National Comprehensive Cancer Network clinical guidelines, these services should be considered standard of care for women with a known BRCA mutation and increased risk for breast and ovarian cancer.
“Working with Michigan health plans as well as the Michigan Association of Health Plans to increase breast cancer screening, genetic counseling and testing, in order to identify women with an inherited cancer risk is incredibly beneficial,” said James K. Haveman, Director of the MDCH. “Michigan health plans can make a tremendous difference in terms of patient access to genetic testing and services, and BCBSM and BCN have exemplary policies that can serve as a model for other health plans.”
Additional Michigan health plans have been receptive to learning more about family history and cancer risk. MDCH is now focusing on access to care and available services for women who test positive for a BRCA mutation. These women have a lifetime risk of breast cancer that increases to 60-85 percent more than the general population risk of 12 percent, and the lifetime risk of ovarian cancer rises dramatically as well.
MDCH encourages Michigan residents to collect their cancer family history, record it, and share it with their healthcare provider. There are many screening tests for inherited cancers, and with proper screening and management, providers and patients can gain some control over future cancer risks. But it’s critical that patients learn their family medical history and talk to their healthcare providers.
For additional information on the MDCH Cancer Genomics Program and their work with Michigan health plans visit www.michigan.gov/genomics or www.mahp.org.