{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:52:25Z","timestamp":1790632345471,"version":"4.1.0"},"reference-count":38,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ontario Ministry of Health (MOH)","award":["315358"],"award-info":[{"award-number":["315358"]}]},{"name":"Ontario Ministry of Health (MOH)","award":["14847"],"award-info":[{"award-number":["14847"]}]},{"name":"Ministry of Long-Term Care (MLTC)","award":["315358"],"award-info":[{"award-number":["315358"]}]},{"name":"Ministry of Long-Term Care (MLTC)","award":["14847"],"award-info":[{"award-number":["14847"]}]},{"DOI":"10.13039\/501100000147","name":"Canadian Cancer Society","doi-asserted-by":"publisher","award":["315358"],"award-info":[{"award-number":["315358"]}],"id":[{"id":"10.13039\/501100000147","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000147","name":"Canadian Cancer Society","doi-asserted-by":"publisher","award":["14847"],"award-info":[{"award-number":["14847"]}],"id":[{"id":"10.13039\/501100000147","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["315358"],"award-info":[{"award-number":["315358"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["14847"],"award-info":[{"award-number":["14847"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Purpose: To effectively reduce cancer burden, genetic testing programs should identify high-risk individuals prior to cancer development, when risk-reduction strategies can be implemented. We evaluated trends in BRCA1\/BRCA2 testing use after implementation of a publicly funded testing program. Methods: We conducted a retrospective, near population-based study of women who underwent BRCA1\/BRCA2 testing in Ontario, Canada, (2007\u20132016) (n = 15,986). Temporal trends were evaluated using linear and Poisson regression. Results: Although annual utilization of testing increased over time (p &lt; 0.001), mean age at testing increased from 49.9 years (SD 13.8) in 2007 to 53.8 years (SD 13.7) in 2016 (p &lt; 0.001). The proportion of women with a cancer history at testing also increased from 53.5% in 2007 to 66.3% in 2015 (p &lt; 0.001); the proportion of women free from breast cancer did not change significantly (49.2% in 2007 versus 45.1% in 2015, p = 0.90). As a proportion of all tested, those with breast cancer tested within 3 months of diagnosis increased over time (0.39% of tests in 2007 versus 13.6% of tests in 2015; p &lt; 0.001). Conclusions: While the institution of a publicly funded genetic testing program was associated with rising utilization, increasing age at testing and decreasing testing of unaffected women suggest limitations in identifying high-risk individuals eligible for risk-reduction.<\/jats:p>","DOI":"10.3390\/curroncol32080439","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T10:13:51Z","timestamp":1754475231000},"page":"439","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Trends in the Utilization of BRCA1 and BRCA2 Testing After the Introduction of a Publicly Funded Genetic Testing Program"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4670-7445","authenticated-orcid":false,"given":"Fahima","family":"Dossa","sequence":"first","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4793-4620","authenticated-orcid":false,"given":"Nancy N.","family":"Baxter","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia"},{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5S 1A1, Canada"},{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Li Ka Shing Knowledge Institute, Unity Health, Toronto, ON M5C 2T2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinku","family":"Sutradhar","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5S 1A1, Canada"},{"name":"ICES, Toronto, ON M4N 3M5, Canada"},{"name":"Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tari","family":"Little","sequence":"additional","affiliation":[{"name":"Medical Genetics, London Health Sciences Centre, London, ON N6A 5W9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Velsher","sequence":"additional","affiliation":[{"name":"Genetics Program, North York General Hospital, Toronto, ON M2K 1E1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3685-5679","authenticated-orcid":false,"given":"Jordan","family":"Lerner-Ellis","sequence":"additional","affiliation":[{"name":"Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada"},{"name":"Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON M5G 1X5, Canada"},{"name":"Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health System, Toronto, ON M5G 1X5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8037-9556","authenticated-orcid":false,"given":"Andrea","family":"Eisen","sequence":"additional","affiliation":[{"name":"Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Metcalfe","sequence":"additional","affiliation":[{"name":"Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5S 1A1, Canada"},{"name":"Women\u2019s College Research Institute, Toronto, ON M5S 1B2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1001\/jama.2017.7112","article-title":"Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers","volume":"317","author":"Kuchenbaecker","year":"2017","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1038\/nature03445","article-title":"Targeting the DNA repair defect in BRCA mutant cells as a therapeutic strategy","volume":"434","author":"Farmer","year":"2005","journal-title":"Nature"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1056\/NEJMoa0900212","article-title":"Inhibition of poly (ADP-ribose) polymerase in tumors from BRCA mutation carriers","volume":"361","author":"Fong","year":"2009","journal-title":"N. 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