Timing of Genetic Counseling for Breast Cancer Pits Health Insurers Against OB-GYN Lobby

Everybody agrees that genetic counseling is an important part of the diagnostic and education process for breast cancer patients, reports Kaiser Health News (KHN). But the American Congress of Obstetricians and Gynecologists thinks that patients should see genetic counselors after the tests. Such tests include, for instance, one that looks for mutations in two genes, BRCA1 and BRCA2, that increase the risk for breast, ovarian and other cancers. Doctors say that asking patients about their family histories is part of their routine examination.

On the other hand, some national insurers, such as UnitedHealthcare and Cigna, require patients to receive counseling by a certified genetic counselor before the tests are approved. Jeffrey Hankoff, Cigna’s medical officer for clinical performance and quality, tells KHN that “We had concerns that people were having testing ordered that didn’t appear to need it and probably didn’t understand it…. Too often the wrong tests were being ordered.”