The Tribune

By SANCHESKA DORSETT

Tribune Staff Reporter

sdorsett@tribunemedia.net

HEALTH Minister Dr Duane Sands said he is looking at how best the government can draft legislation to prevent persons who test positive for the BRCA 1 and BRCA 2 gene mutations, which increase a woman’s chances of developing cancer, from being denied health insurance.

Dr Sands told The Tribune that in the absence of legislation, women can be left with significantly high hospital bills or may not receive treatment at all decreasing chances of beating the disease if they develop cancer.

His comments came after a study published in The Journal of the American Medical Association (JAMA) found that women with BRCA1 mutations have on average a 72 per cent risk of developing breast cancer by the age of 80.

For BRCA2 mutation carriers, the risk of breast cancer is 69 per cent. The average lifetime risk of ovarian cancer is 44 per cent for BRCA1 and 17 per cent for BRCA2, according to the study.

It was also found that the location of where the abnormality is found in the gene and family history influenced the risk.

Last week, while making his contribution to the budget debate in the House of Assembly, Dr Sands said women in the Bahamas have the highest incidents of BRCA1 and BRCA2 “which is 800 per cent higher than the world average.”

“What this means is that women in the Bahamas with these genes are three to five times (likelier) to get breast and ovarian cancer than those without those genes,” Dr Sands said in Parliament.

On Wednesday, the health minister said the results of the JAMA study is “worrisome”.

“A lot of the work that was done in the study was done studying Bahamian women. Several doctors have collaborated with the study and I found it worrisome but it is consistent with what we already know and what we found. There are still studies going on to determine the overall prevalence of the BRCA gene. The gene is in men as well but we still have no idea how it affects men and that is troubling,” Dr Sands said.

“In the absence of legislation to protect persons who have these genes, we can end up with a lot of persons with no insurance and we have to protect our people. We cannot have Bahamians being discriminated against. These are the conversations we ought to have. We need to address this so we are looking at legislation. I have had very progressive discussions with the Bahamas Insurance Association (BIA) and we talked about a lot of the issues. So, I am heartened by our discussions.”

The JAMA study also found cancer risk increased rapidly at a young age and peaked in a person’s 30s for BRCA 1 mutation carriers and in the 40s for BRCA 2 mutation carriers.

But it remained as the woman aged, overturning previous thinking that the risk reduced when a woman turned 60 without a diagnosis.

Oncologist professor Kelly-Anne Phillips, founder of the Peter Mac Breast and Ovarian Cancer Risk Management Clinic, said the study “is the largest and most scientifically rigorous study to date.”

The study included data from a large number of studies running internationally.