Estonia to calculate breast cancer risk for all 40-year-old women

Estonia will invite all 40-year-old women to genetic testing next week to assess their individual risk of breast cancer, regardless of whether they have health insurance, ERR reports. The initiative is intended to make Estonia the first country to use genetic data to invite people for screening.

Women have previously been invited for breast cancer screening after turning 50. The new assessment will use about 3,000 genetic variants to identify women whose risk is higher than usual. If a 40-year-old woman’s risk is comparable to that of an average 50-year-old, starting mammography at 40 may be appropriate, said Steven Smit, head of the laboratory at the Estonian Biobank.

The assessment does not cover BRCA gene mutations, which are evaluated separately when needed, including when breast cancer has occurred in a family, Smit said.

Nearly 10,000 women in Estonia are 40 years old. Both Biobank donors and women whose genetic data are not held there will receive an invitation. Donors must first submit consent through the health portal for their data to be used in the healthcare system, said Krista Kruuv-Käo, head of prevention services at the Estonian Health Insurance Fund. Women without data in the Biobank must also give consent and will receive a referral to provide a blood sample.

The Health Insurance Fund is also examining how genetic risk could help target prevention of cardiovascular disease. It does not consider it practical to assess other serious disease risks at present because the state would not have the capacity to follow up on them.

The Biobank holds data on about one-fifth of Estonia’s population, but is not currently accepting new donors. Smit said it was ready to do so but lacked the necessary funding, and its overall funding had been reduced in recent years.