Abstract
Genetic services of hereditary breast and ovarian cancer (HBOC) has already become very common among clinicians of breast cancer in United States for about 20 years after identification of BRCA 1/2 genes. In contrast, either genetic counseling or test of HBOC have not yet been covered by health insurance in Japan. Especially risk reduction surgeries are performed only in the limited institutes being permitted by the institutional review boards. I guess the lack of education causes the lack of awareness of HBOC among the medical doctors and staffs working in breast cancer fields and this lack of awareness is the main reason why spread of HBOC is so delayed in Japan compared with the other developing countries. Kochi prefecture, where our institute is situated, has small medical and human resources because of small population about 736,000 with rapid depopulation. In these situations we established the genetic service system for HBOC cooperating with the genetic counseling service in our institute and educating medical staffs through the existing socio-medical networks of breast cancer, namely Kochi Breast Cancer Study Group, non-profit organization ″Kochi-ken no nyuugan wo kangaeru kai″ and several cancer patient associations. We introduce the actual state of genetic service of HBOC in our institute and presenting issues in Kochi.
