Estonia to invite 40-year-old women for breast cancer risk assessment — ERR News

In Estonia, next week all women aged 40 will receive invitations to undergo genetic testing to assess their individual risk of developing breast cancer. They will receive invitations regardless of whether they have health insurance. As ERR News reports, the country may become the first in the world to invite people to screening programs based on genetic data.

Early screening for women at increased risk

Until now, invitations for breast cancer screening in Estonia were sent to women after they turned 50. Under the new procedure, the personal risk of each 40-year-old participant will be determined. If it is the same as the average risk among women aged 50, the patient may be included in screening earlier and begin mammography from the age of 40.

The calculation will take into account around 3,000 genetic variants. At the same time, the assessment does not cover BRCA gene mutations linked to hereditary forms of cancer. Such cases are checked through separate tests when necessary, including if there has been breast cancer in the family.

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Consent to use genetic data

There are nearly 10,000 women aged 40 in Estonia. Invitations will be received both by data donors of the Estonian Genome Centre and by those who have not previously submitted genetic material. The data of existing donors will not be checked automatically: women must first submit a declaration through the Health Portal consenting to the use of this data in the healthcare system.

Women whose data are not held by the Genome Centre will, after submitting such a declaration, receive a referral to a laboratory to provide a blood sample. The Genome Centre currently stores data on approximately one-fifth of Estonia's population, but does not accept new donors due to a lack of funding.

The Estonian Health Insurance Fund is also analyzing the possibility of using genetic risk assessment for cardiovascular diseases. At the same time, the fund does not consider it appropriate to introduce such a service for other serious illnesses, as the state does not have sufficient capacity for subsequent patient follow-up.