Uptake and timing of bilateral prophylactic salpingo-oophorectomy among BRCA1 and BRCA2 mutation carriers.

PURPOSE: To evaluate prophylactic salpingo-oophorectomy uptake and timing among BRCA1/2 mutation carriers in a cancer risk assessment program. METHODS: Clinical records of female BRCA1/2 mutation carriers who received cancer genetic counseling between 1996 and 2003 were reviewed to determine the completion and the timing of prophylactic salpingo-oophorectomy. Logistic regression models evaluated associations between subject characteristics and surgery. Survival analysis methods were used to estimate the distribution of time to surgery. RESULTS: Among 88 women, 70% underwent prophylactic salpingo-oophorectomy. Prophylactic salpingo-oophorectomy was associated with older age, white race, having children, and a family history of ovarian cancer. Many women waited more than 12 months to undergo surgery and some delayed by several years. Younger age and not having children were associated with delays to surgery. CONCLUSION: Prophylactic salpingo-ooporectomy is an acceptable risk reduction measure for many BRCA1/2 mutation carriers. Some women make this decision many years after genetic testing. Continued discussion of the risks and benefits of risk reduction options may facilitate the uptake of recommended risk reduction interventions among BRCA mutation carriers.

Status of genetics education in U.S. dental schools.

Genomics research is rapidly increasing our understanding of the genetic basis of normal and abnormal growth, development, and disease. Genetic information and technologies are also being applied to develop new diagnostic and treatment strategies. Many diseases with dental, oral, and craniofacial manifestations have a genetic basis. Effective clinical application of genomics to oral medicine will depend on the education of health care professionals, the general public, and policymakers. Dentists must understand genetics to provide accurate information to patients and be able to discuss benefits and limitations of the biological, clinical, and ethical issues related to genomic-based health care. Genetics education in dental schools will significantly impact the integration of genetics into oral medicine. Fifty-three U.S. dental schools completed a survey in 2001 to assess the status of genetics curricula in dental schools in the United States. Ninety-four percent of schools did not require genetics education for entry to dental school, and a formal genetics course was conducted in only eight of the fifty-three schools (15 percent). The genetics education currently offered to undergraduate dental students is not standardized, and the content varies considerably among schools. These findings suggest more emphasis on genetics education is needed in U.S. dental schools.