Prognosis Of The Incidence Rates Of Ovarian Cancer With BRCA1/2 Gene Mutations
Objective of the study: To analyze the prevalence and incidence rates of ovarian cancer taking into account the data of genotyping for BRCA1/2-status in the Russian female population, to construct a clinical-statistical model, which would allow to predict the prevalence rate of hereditary ovarian cancer considering the stage of the disease. Also the objective is to identify the demand in the introduction of screening programmes, which would contribute to detect hypothetical patients (first-second degree relatives of ovarian cancer patients), who are considered to be at risk of developing ovarian cancer and are subject to undergo mandatory testing. Materials and Methods: An information retrieval search of the data regarding the prevalence and incidence of ovarian cancer in the Russian Federation, including patients with BRCA1/2 gene mutations, of clinical recommendations relating to the course and outcomes of the disease in different clinical groups of patients was conducted. Results: Considering the probabilities introduced into the model it was established that if the number of newly detected patients with ovarian cancer and BRCA1/2 gene mutations at an early stage may make up from 326 to 486 people, then with advanced cancer - from 1197 to 1437 people. If we consider the whole population of patients with a proven diagnosis of ovarian cancer who are registered at the cancer centers and institutes of the Russian Federation, the number of patients with BRCA1/2 gene mutation at present is from 13 206 до 14 329 people. An expert-based evaluation demonstrates that 1683-1762 relatives of patients will be identified as BRCA1/2 gene mutation carriers, and 673-705 individuals will develop ovarian cancer in the lifetime (the risk of the development of this subtype of ovarian cancer is 0,4). The survival rate in a «test group» is 2,4 times higher compared to the group of relatives who haven’t been tested. Conclusions: It is feasible to perform the testing on BRCA1/2 gene mutation in all ovarian cancer patients regardless of family medical history that is stipulated by both clinical and clinical-economic indicators. The identification of a sub-group of patients with BRCA1/2 - associated cancer, relatives - who are the carriers of BRCA mutations will provide an opportunity to avoid a burden on state budget in social service sector, as well as on the budgets of healthcare sector of different levels in connection with the optimization of existing treatment regimens.