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Genetic Discrimination and the BRCA1 Gene

written by: Leigh A. Zaykoski•edited by: Leigh A. Zaykoski•updated: 5/17/2011

Have you been turned down for health insurance or employment because of a genetic mutation in your medical history? You're not alone. Read more about genetic discrimination and how it affects people with a mutation of the BRCA1 gene.

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    Definition

    Genetic discrimination is the unfair treatment of a person based on variations in their genes that predispose them to certain diseases. This type of discrimination can take on several forms, including discrimination by employers and discrimination by health insurance companies. Employers may discriminate against someone with a genetic mutation by refusing to hire them on the basis that they may become ill and unable to work in the future. Health insurers may discriminate against someone with a genetic abnormality by denying health insurance coverage because they may develop a disease that is costly to treat.

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    The BRCA1 Gene

    One of the genetic mutations that can lead to discrimination is a defect in the BRCA1 gene. The BRCA1 gene is a gene that can be categorized as a tumor suppressor. It has functions that include the regulation of transcription and the repair of damaged DNA. When the BRCA1 gene is not damaged, it functions as a control to ensure that cells do not divide rapidly or divide uncontrollably. When the BRCA1 gene is damaged, these functions cannot be carried out normally, so people with this type of genetic defect are predisposed to developing breast cancer, ovarian cancer, pancreatic cancer and cancer of the fallopian tubes. If someone undergoes genetic testing and the test reveals a mutation of the BRCA1 gene, she has several options for managing the increased risk for cancer. Some women with elevated cancer risk decide to undergo preventive mastectomies -- removal of breast tissue -- to prevent cancer from developing. Others use a more conservative approach to managing their cancer risk. They may get mammograms more often and see a doctor every six months instead of every year.

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    Privacy of Genetic Testing Results

    If someone is tested and found to have one of the more than one thousand BRCA1 gene mutations, these tests results may be placed in personal medical files. While HIPAA protects patients from some invasions of privacy, there are legitimate ways in which a potential employer or a health insurance company can access your medical records. When you apply for health insurance, you may need to sign an application that gives the insurance company permission to access your medical records. If you plan to become employed by the military, your medical records will also be accessed.

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    The Future

    In May 2008, the Genetic Information Nondiscrimination Act of 2008 became law in the United States. This law prohibits discrimination on the basis of genetic information. Although the law applies to employers and health insurance companies, it does not apply to companies offering long-term care insurance, disability coverage and life insurance policies. In the future, other countries may consider adopting this type of policy to prevent employment discrimination and discrimination in the health insurance market.

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    References

    U.S. Equal Employment Opportunity Commission: Genetic Information Discrimination

    National Human Genome Research Institute: Genetic Information Nondiscrimination Act of 2008

    National Cancer Institute: BRCA1 and BRCA2: Cancer Risk and Genetic Testing