Insurers mull cancer gene tests

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UK insurers have told an advisory body they may seek approval to use the results of genetic tests for inherited cancers in setting premiums after 2007.

This would allow insurers to ask about tests for gene mutations linked to breast and ovarian cancer.

Approval applies to high value policies only; a moratorium exists on the use of genetic tests in all other policies.

But campaigners fear such proposals could be expanded if the moratorium is not renewed once it runs out in 2011.

At present, the Association of British Insurers (ABI) has to ask the Genetics and Insurance Committee (GAIC), which advises the government on the issue, for permission to request details from customers of genetic tests.

Since 1999, the GAIC has approved just one application, which allows insurers to use predictive test results for Huntington's disease in life insurance policies over £500,000.

"The ABI has said that it may come forward with applications covering specific predictive genes for hereditary breast and ovarian cancer, but not until 2008 at the earliest," the Department of Health's Genetics and Insurance Committee said in its most recent update.

Predictive test

Last year, newspapers reported that the ABI would seek official permission to use predictive tests for the illnesses, but the association subsequently declined to submit an application in 2006/2007.

A spokesperson for the ABI reiterated that no application would be submitted for this period but did not dispute the statement in the GAIC report.

The basis for the tests are mutations or changes in the genes BRCA-1 and BRCA-2 carried by some individuals. These changes have a dramatic effect on the chances of a woman developing the diseases.

Female carriers of BRCA-1 mutations have a lifetime risk of breast cancer exceeding 80% and of ovarian cancer approaching 60%. Carriers of BRCA-2 mutations have a similar risk of breast cancer and a more moderately increased risk of ovarian cancer.

BRCA mutations account for about 5% of the 44,000 new cases of breast cancer each year in Britain and 10% of the 7,000 ovarian cancers diagnosed annually.

The voluntary UK moratorium covers income protection policies up to the value of £30,000 per year, critical illness up to the value of £300,000, and life insurance of £500,000. It accounts for about 97% of insurance policies.

Above these ceilings, insurance companies can use the results of tests approved by the GAIC.

Legislation call

Some campaigners are worried about this apparent renewal of interest by insurers in predictive tests for BRCA genes.

Dr Helen Wallace, director of GeneWatch UK, told BBC News: "If the committee approves an application, it will only be for those high value policies initially; but once the moratorium runs out in 2011, it could mean that it is applied much more widely.

"We still think the industry should drop plans to use these genetic test results at all and that there should be legislation to prevent the insurance industry from refusing someone insurance, or charging a higher premium on the basis of a predictive genetic test."

There are concerns that members of the public will decline to take genetic tests for hereditary illnesses because of fears over how the results could be used.

A spokeswoman for the Department of Health said: "Choosing to have a predictive genetic test can be life-saving, and nobody should be put off having such a test because of fears it will be used against them by insurers.

"Genetic tests that may predict disease have only recently been developed, but the current moratorium we negotiated with the Association of British Insurers (ABI) sets out a stable and sensible environment to help support the future development of genetics."

In the US, the Genetic Information and Non-discrimination Act (Gina) has been passed by the House of Representatives and will go before the Senate later this year.

The act would prohibit insurers from requesting or using genetic information when establishing premiums and prevent employers from using such information when hiring or promoting individuals.

The UK moratorium on the use of predictive genetic tests is due to stand until November 2011.