title: Experiences from a pilot program bringing BRCA1/2 genetic screening to theUS Ashkenazi Jewish population.
abstract: The notion of offering population-based screening to the Ashkenazi Jewish (AJ) population for the BRCA1/2 founder mutations continues to gain support. A program called the BRCAcommunity initiative was designed to identify the benefits and barriers associated with implementing this screening in a clinical setting.
  
  
  
  Interested AJ individuals were stratified into high-risk (HR) and low-risk (LR) groups based on self-reported cancer histories. Those at HR were offered traditional genetic counseling/testing; those at LR were offered group genetic counseling and subsidized AJ BRCA founder mutation testing.
  
  
  
  During the pilot year, 62% of initial registrants and 53% of ultimate study participants were classified into the HR group. Among the 101 HR and 88 LR study participants, 8 and 2 BRCA carriers were identified, respectively. The LR carriers would have been missed by current mechanisms. Survey responses provided insight into the motivations and fears associated with pursuing testing, the efficacy of the initiative design, and challenges that exist on multiple levels, including the community, health-care providers, and insurance coverage.
  
  
  
  Although the medical value of identifying presymptomatic BRCA carriers in Ashkenazi Jews is evident, further measures need to be taken before this effort can be accomplished on a large scale.Genet Med advance online publication 13 October 2016.
authors.affiliation: Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.|Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Chana
authors.initials: C
authors.lastname: Wiesman
authors.affiliation: Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.|Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Esther
authors.initials: E
authors.lastname: Rose
authors.affiliation: Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Grant
authors.affiliation: Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Adam
authors.identifier: 0000-0002-4819-8453
authors.initials: A
authors.lastname: Zimilover
authors.affiliation: Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.|Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Susan
authors.identifier: 0000-0001-8775-008X
authors.initials: S
authors.lastname: Klugman
authors.affiliation: Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.|Program for Jewish Genetic Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.|Department of Genetics, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Nicole
authors.identifier: 0000-0002-6771-1080
authors.initials: N
authors.lastname: Schreiber-Agus
mesh_terms: D000328:Adult; D000368:Aged; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D018703:Founder Effect; D006580:Genetic Carrier Screening; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D006306:Health Surveys; D006801:Humans; D007585:Jews / Q000235:genetics*; D008403:Mass Screening; D008875:Middle Aged; D010865:Pilot Projects; D014481:United States / Q000208:ethnology
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human