{"entity":{"id":"idea-prev-population-germline-screening-at-30","kind":"idea","name":"Offer everyone at 30 a test for the cancer genes that matter","aka":[],"tldr":"Most people with BRCA or Lynch mutations do not know until they get cancer. Testing everyone once for a short list of high-impact genes would find them in time to prevent it.","summary":"Population screening for CDC Tier 1 conditions (BRCA1/2, Lynch syndrome, familial hypercholesterolaemia) has been piloted in Geisinger MyCode, the Healthy Nevada Project, and Jewish BRCA programmes, finding that most carriers would not meet family-history criteria. Propose a national programme at age 30 with tiered disclosure and linked prevention pathways.","asOf":"2026-09-08","links":[{"label":"Healthy Nevada Project","url":"https://healthynv.org"},{"label":"Our Future Health","url":"https://ourfuturehealth.org.uk"}],"tags":[],"related":[],"cancers":[],"sections":["prevention"],"technologies":["germline-testing"],"targets":["brca"],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-hereditary-risk"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Population screening identifies at least half of carriers who would otherwise be missed by family-history criteria, at a cost per QALY under $50,000.","rationale":"Family-history criteria miss about half of carriers, and test costs have fallen below cost-effectiveness thresholds in UK and US modelling.","test":"Regional pilot in 100,000 people with uptake, carrier yield, and prevention uptake as endpoints.","maturity":"being-tested-at-scale","actor":"policy","cost":"large","horizonYears":5},"route":"/ideas/idea-prev-population-germline-screening-at-30/","neighbours":{"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"technology":[{"id":"germline-testing","kind":"technology","name":"Germline (hereditary) testing","route":"/technologies/germline-testing/"}],"target":[{"id":"brca","kind":"target","name":"BRCA1 / BRCA2 (HRD)","route":"/targets/brca/"}],"bottleneck":[{"id":"b-hereditary-risk","kind":"bottleneck","name":"Inherited risk is mostly unidentified","route":"/bottlenecks/b-hereditary-risk/"}],"paper":[{"id":"paper-brca-risk-reducing-surgery-jama-2010","kind":"paper","name":"PROSE consortium: preventive surgery lowers cancer and death in BRCA1 and BRCA2 carriers","route":"/key-papers/paper-brca-risk-reducing-surgery-jama-2010/"}],"roadmap":[{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"}]}}