Friday, September 26, 2008

When to screen for the breast cancer gene

They're debating whether minors should be screened for the breast cancer gene. They seem to be looking at it in terms of what the potential screenee could do at that particular point in their lives to prevent breast cancer.

But they seem to be missing one key point: the breast cancer gene is hereditary.

Therefore, people should be screened before they become sexually active, so they can make fully-informed decisions about family planning. Some will argue that potential for increased breast cancer risk is no reason not to have kids, but actual carriers of this hereditary gene have first-hand knowledge of what it's like to live with this hereditary gene and the ensuing risks, so they are the best people to make that decision for themselves.

I think the optimal time for testing is when it starts to occur to a person that they might want to have sex one day, so they're at a point where they can see the necessity of having the information, but they still have a bit of time to let it fester before they have to make any decisions. However, this puts the kid in the awkward position of going to their parents and saying "It occurs to me that I might want to have sex one day," with the ensuing potential for parental overreaction. If we have to pick a specific age, I'd say when the kid starts high school would be most appropriate, although some parents will worry that this would give kids tacit permission to have sex starting in high school. The other option would be menarche. Speaking as someone who had early menarche, I would have found the knowledge terrifying at that age (although I also found menstruation and bras and armpit hair terrifying) but people with a family history of breast cancer might feel differently.

At any rate, they're doing people a disservice by not allowing them to be tested before they're sexually active just because they're too young for a preventive masectomy.

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