874 Uptake of population based BRCA-testing across Jewish denominations and affect of cultural and religious factors: a cohort study

Introduction/Background* Population-based BRCA-testing in the Ashkenazi Jewish (AJ) population is feasible, acceptable, reduces anxiety, identifies more BRCA-carriers and is cost-effective. The Jewish population is the first population for whom unselected population testing is now being implemented with Israel recently adopted this into national policy. Guideline change is being advocated in the UK and by others too. It is unknown whether BRCA-testing differs across Jewish denominational affiliations and religious or cultural outlook. We evaluate the association of Jewish cultural and religious identity and denominational affiliation with interest-in, intention-to undertake and uptake-of population-based BRCA-testing Methodology Design Cohort-study set within recruitment to GCaPPS-trial (ISRCTN73338115). AJ men and women, >18years, from London, self-referred, and attended recruitment clinics(clusters) for pre-test counselling. Subsequently consenting individuals underwent BRCA-testing. Mina oucome measures were: Interest, intention, uptake-of BRCA-testing. Participants self-identified to one Jewish denomination: Conservative/Liberal/Reform/Traditional/Orthodox/Unaffiliated. Validated scales measured Jewish Cultural-Identity (JI) and Jewish Religious-identity (JR). 4-item Likert-scales analysed initial ‘interest’ and ‘intention-to-test’ pre-counselling. Item-Response-Theory and graded-response-models, modelled responses to JI and JR scales. Ordered/multinomial logistic regression modelling evaluated association of JI-scale, JR-scale and Jewish Denominational affiliation on interest, intention and uptake-of BRCA-testing. Result(s)* 935 AJ women/men of mean-age=53.8 (S.D=15.02) years, received pre-test education and counselling through 256 recruitment clinic clusters (mean cluster size=3.64). Denominational affiliations included Conservative/Masorti=91(10.2%); Liberal=82(9.2%), Reform=135(15.1%), Traditional=212(23.7%), Orthodox=239(26.7%); and Unaffiliated/Non-practising=135(15.1%). Overall BRCA-testing uptake was 88%. Pre-counselling 96% expressed interest and 60% intention-to test. JI and JR scores were highest for Orthodox, followed by Conservative/Masorti, Traditional, Reform, Liberal and Unaffiliated Jewish denominations. Regression modelling showed no significant association between overall Jewish Cultural or Religious Identity with either interest, intention or uptake-of BRCA-testing. Interest, intention and uptake of BRCA-testing was not significantly associated with denominational affiliation. Conclusion* Jewish religious/cultural identity and denominational affiliation do not appear to influence interest, intention or uptake of population-based BRCA-testing. BRCA-testing was robust across all Jewish denominations.