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Racial Differences in BRCA Testing
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To the Editor: We are concerned about aspects of the study design in the article on racial differences in BRCA1/2 testing by Dr Armstrong and colleagues, and believe that the results should be interpreted with caution.1 In a case-control study, controls should be sampled from the population that gave rise to the cases.2-3 However, the description of this study leaves questions about whether appropriate sampling has occurred.
First, more detail is needed regarding the selection of controls, including the number of women mailed a survey, the proportion of eligible patients obtained from this group, and the characteristics (particularly race) of nonresponders. Second, the predicted risk of a BRCA1/2 mutation is significantly different between the controls (4.62) and the cases (8.40), and almost 60% of the controls (vs 13% of the cases) reported having only a second-degree relative affected. The lower risk in the control group could justify genetic counseling not . . . [Full Text of this Article]
Sharon Hensley Alford, MPH
salford1@hfhs.org
Josephine Ford Cancer Center
Henry Ford Health System
Detroit, Mich
Judy Mouchawar, MD
Medical Genetics
Kaiser Permanente Colorado
Denver
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