title: Current Status of the Management of Hereditary Breast and Ovarian Cancer in Asia: First Report by the Asian BRCA Consortium.
abstract: BACKGROUND
  BRCA1/BRCA2 mutations are associated with an increased lifetime risk for hereditary breast and ovarian cancer (HBOC). Compared with the Western developed countries, genetic testing and risk assessment for HBOC in Asia are less available, thus prohibiting the appropriate surveillance, clinical strategies and cancer management.
  
  
  METHODS
  The current status of HBOC management in 14 Asian countries, including genetic counselling/testing uptakes and clinical management options, was reviewed. We analysed how economic factors, healthcare and legal frameworks, and cultural issues affect the genetic service availability in Asia.
  
  
  RESULTS
  In 2012, only an estimated 4,000 breast cancer cases from 14 Asian countries have benefited from genetic services. Genetic testing costs and the absence of their adoption into national healthcare systems are the main economic barriers for approaching genetic services. Training programmes, regional accredited laboratories and healthcare professionals are not readily available in most of the studied countries. A lack of legal frameworks against genetic discrimination and a lack of public awareness of cancer risk assessment also provide challenges to HBOC management in Asia.
  
  
  CONCLUSIONS
  The Asian BRCA Consortium reports the current disparities in genetic services for HBOC in Asia and urges the policy makers, healthcare sectors and researchers to address the limitations in HBOC management.
authors.affiliation: Department of Surgery, Division of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Seigo
authors.initials: S
authors.lastname: Nakamura
authors.forename: Ava
authors.initials: A
authors.lastname: Kwong
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Philip
authors.initials: P
authors.lastname: Iau
authors.forename: Pimpicha
authors.initials: P
authors.lastname: Patmasiriwat
authors.forename: Rodney
authors.initials: R
authors.lastname: Dofitas
authors.forename: Teguh
authors.initials: T
authors.lastname: Aryandono
authors.forename: Zhen
authors.initials: Z
authors.lastname: Hu
authors.forename: Chiun-Sheng
authors.initials: CS
authors.lastname: Huang
authors.forename: Ophira
authors.initials: O
authors.lastname: Ginsburg
authors.forename: Muhammad Usman
authors.initials: MU
authors.lastname: Rashid
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sarin
authors.forename: Soo-Hwang
authors.initials: SH
authors.lastname: Teo
mesh_terms: D000328:Adult; D001208:Asia / Q000453:epidemiology; D044466:Asian People / Q000235:genetics; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D003431:Cross-Cultural Comparison; D019468:Disease Management; D005260:Female; D005817:Genetic Counseling / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D005820:Genetic Testing / Q000379:methods / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D061325:Hereditary Breast and Ovarian Cancer Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000628:therapy; D006801:Humans; D020380:Needs Assessment; D018570:Risk Assessment
chemical_list: D019313:BRCA1 Protein; D024682:BRCA2 Protein