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Some people inherit genes that put them at a much higher risk of developing cancer. For example, a young woman with a BRCA1 gene mutation has a 75% chance of developing breast cancer and a 44% chance of ovarian cancer in her lifetime—far higher than the average risks of 12% and 1.3%. But if she knows about her risk early, she can take steps like regular screening or preventive surgery, which can lower her risk and improve her chances of survival by up to 70%.

Although about 1 in 100 people carry these high-risk genes, over 95% don’t know it because they haven’t had genetic testing. Right now, testing is only publicly funded for people with a personal or family history of cancer. This leaves out many people—especially Indigenous and non-European Canadians—who are less likely to be referred for testing, increasing health inequities.

A new approach called population-based testing (PBT) could help. It offers genetic testing to everyone, not just those with a family history. Canadian studies show that PBT could prevent over 3,000 cases of breast and ovarian cancer per million women and is cost-effective.

This project has two parts. First, it will gather input from the public, healthcare providers, and people with BRCA mutations to understand how a PBT program should be designed. Then, a small pilot study will test how acceptable and effective the program is. These results will help shape a future PBT strategy for British Columbia.