One hospital's push to bring genetic cancer testing to more Black women

Breast cancer tends to hit Black women at younger ages and be more aggressive, but they're underrepresented when it comes to genetic screening, say doctors launching a new awareness campaign. 

The awareness campaign, announced Wednesday by Women's College Hospital in Toronto, focuses on genetic screening for changes or mutations in two key genes, BRCA1 and BRCA2, as well as others.  

Dr. Aisha Lofters, a family physician and researcher at the hospital, helped start the Take Action, Take Control initiative that is designed to empower Black women to learn more about genetic cancer testing.

Screening aims to catch a disease like breast cancer before it causes any problems that the patient notices, Lofters said. 

"The idea of that is that by catching it very early, you're able to change the path of that disease, so you're actually able to literally save lives," she said in an interview. 

When the BRCA1 or BRCA2 genes aren't working properly due to mutations, they are strongly associated with breast, ovarian and prostate cancers. According to Women's College Hospital, it's estimated one in every 300 to 400 Canadians carries a BRCA1/2 gene mutation, which is about the same in the U.K. and more common in the U.S.

The hospital and Canadian Cancer Society estimate BRCA mutations predispose people to a higher lifetime risk of cancers compared with the average lifetime risk in the general population:  

Researchers at Women's College Hospital say Black people are vastly underrepresented in its Screen Project program, making up 1.5 per cent of participants since it launched in 2017. Black individuals make up 9.6 per cent of Toronto's overall population. 

"We see these genes occurring in all ethnic and racial communities, but what we do realize is that the knowledge about these genes is lower than it should be in the Black community," said Lofters.

The screening is done through blood tests, cheek swabs or saliva samples. The Screen Project is promoting saliva based self-test kits for a fee and results take up to eight weeks. 

Provincial programs cover the testing and genetic counselling depending on immediate family history or if an individual has cancer. Other people with a less direct connection to cancer can choose to pay several hundreds of dollars out of pocket for direct-to-consumer testing, which provide results alone and may not include genetic counselling. 

Elysia Bryan of Toronto was offered free genetic provincial screening after she noticed a lump growing on her right breast in 2021 when she was 34.

"My first thought was 'I'm going to die,' " Bryan recalled. "My mind went to the darkest possible option, and I know now that the doctor was telling me at the time it was treatable."

Bryan, who had a lumpectomy and eight rounds of chemotherapy, has a family history of breast cancer, which she wasn't aware of at the time of her diagnosis. She says that's what "opened up that conversation," with her family.