Rates of @entity6069 mutation testing among young survivors of XXXX .

@entity1 @entity0 @entity5345 @entity2674 @entity6069
UNASSIGNED: Guidelines in the United States recommend consideration of testing for mutations in the @entity5345 and @entity2674 genes for @entity1 diagnosed with @entity0 under age 45. Identification of mutations among survivors has implications for secondary prevention and familial risk reduction. Although only 10  % of @entity0 are diagnosed under age 45, there are approximately 2.8  million @entity0 survivors in the United States, such that the young survivor population likely numbers in the hundreds of thousands. However, little is known about genetic testing rates in this population. We assessed trends in @entity6069 testing among @entity0 survivors who were under age 45 at diagnosis and were treated from 2005 to 2012. Using insurance claims from a national database (MarketScan), we identified incident @entity0 cases among (1) @entity1 aged  <=40 and (2) @entity1 aged 41-45. We measured @entity5345 /2 testing using Kaplan-Meier analysis and Cox proportional hazards models. Among 26,985 @entity1 analyzed, @entity5345 /2 testing rates increased with each year of diagnosis from 2005 to 2012 (P  <  0.001). However, among @entity1 treated in earlier years, testing rates did not approach those of @entity1 treated later, even after extended follow-up (median time from surgery to testing among @entity1 treated in 2005, not reached; median time to testing among @entity1 treated in 2012, 0.2  months for @entity1 aged  <=40 and 1.0  month for @entity1 aged 41-45). @entity1 aged 41-45 had lower rates than @entity1 aged  <=40 throughout the analysis period (P  <  0.001 for each year). @entity6069 testing rates among young @entity1 with incident @entity0 increased substantially in the last decade. However, most survivors treated in earlier years have never been tested. Our results demonstrate a need to better incorporate genetic counseling into survivorship and primary care for this population.
