{"id":"https://openalex.org/W7204663779","doi":"https://doi.org/10.1186/s12885-026-16878-3","title":"Insurance expansion shortened time to BRCA testing and facilitated preventive strategies: a single-center cohort study in Japan","display_name":"Insurance expansion shortened time to BRCA testing and facilitated preventive strategies: a single-center cohort study in Japan","publication_year":2026,"publication_date":"2026-08-29","ids":{"openalex":"https://openalex.org/W7204663779","doi":"https://doi.org/10.1186/s12885-026-16878-3"},"language":"en","primary_location":{"id":"doi:10.1186/s12885-026-16878-3","doi":"https://doi.org/10.1186/s12885-026-16878-3","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12885-026-16878-3","pdf_url":null,"source":{"id":"https://openalex.org/S192926780","display_name":"BMC Cancer","issn_l":"1471-2407","issn":["1471-2407"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Cancer","raw_type":"journal-article"},"parent_works":[],"lineage":["https://openalex.org/W7204663779"],"child_works_count":0,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12885-026-16878-3","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":null,"display_name":"Mami Kaneko","orcid":"https://orcid.org/0009-0003-6843-3494","observed_orcids":["https://orcid.org/0009-0003-6843-3494"]},"institutions":[{"id":"https://openalex.org/I4210119324","display_name":"Ishikawa Prefectural Central Hospital","ror":"https://ror.org/02cv4ah81","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210119324"]}],"countries":["JP"],"is_corresponding":true,"raw_author_name":"Mami Kaneko","raw_affiliation_strings":["Department of Breast surgery, Ishikawa Prefectural Central Hospital, 2-1, KuratsukiHigashi , Kanazawa, Ishikawa, 920-8530, Japan","Department of Medical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan"],"raw_orcid":"https://orcid.org/0009-0003-6843-3494","affiliations":[{"raw_affiliation_string":"Department of Breast surgery, Ishikawa Prefectural Central Hospital, 2-1, KuratsukiHigashi , Kanazawa, Ishikawa, 920-8530, Japan","institution_ids":["https://openalex.org/I4210119324"]},{"raw_affiliation_string":"Department of Medical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan","institution_ids":["https://openalex.org/I4210119324"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5087125829","display_name":"Atsushi Nohara","orcid":"https://orcid.org/0000-0002-2586-5727","observed_orcids":["https://orcid.org/0000-0002-2586-5727"]},"institutions":[{"id":"https://openalex.org/I4210119324","display_name":"Ishikawa Prefectural Central Hospital","ror":"https://ror.org/02cv4ah81","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210119324"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Atsushi Nohara","raw_affiliation_strings":["Department of Medical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Medical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan","institution_ids":["https://openalex.org/I4210119324"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5079101485","display_name":"Masayoshi Munemoto","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210119324","display_name":"Ishikawa Prefectural Central Hospital","ror":"https://ror.org/02cv4ah81","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210119324"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Masayoshi Munemoto","raw_affiliation_strings":["Department of Breast surgery, Ishikawa Prefectural Central Hospital, 2-1, KuratsukiHigashi , Kanazawa, Ishikawa, 920-8530, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Breast surgery, Ishikawa Prefectural Central Hospital, 2-1, KuratsukiHigashi , Kanazawa, Ishikawa, 920-8530, Japan","institution_ids":["https://openalex.org/I4210119324"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5109456905","display_name":"Yuka Nishimura","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210119324","display_name":"Ishikawa Prefectural Central Hospital","ror":"https://ror.org/02cv4ah81","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210119324"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Yuka Nishimura","raw_affiliation_strings":["Department of Breast surgery, Ishikawa Prefectural Central Hospital, 2-1, KuratsukiHigashi , Kanazawa, Ishikawa, 920-8530, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Breast surgery, Ishikawa Prefectural Central Hospital, 2-1, KuratsukiHigashi , Kanazawa, Ishikawa, 920-8530, Japan","institution_ids":["https://openalex.org/I4210119324"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112157164","display_name":"Takayoshi Kawabata","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210119324","display_name":"Ishikawa Prefectural Central Hospital","ror":"https://ror.org/02cv4ah81","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210119324"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Takayoshi Kawabata","raw_affiliation_strings":["Department of Medical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Medical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan","institution_ids":["https://openalex.org/I4210119324"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5007535025","display_name":"Shigenori Wakita","orcid":"https://orcid.org/0000-0002-8537-7653","observed_orcids":["https://orcid.org/0000-0002-8537-7653"]},"institutions":[{"id":"https://openalex.org/I4210119324","display_name":"Ishikawa Prefectural Central Hospital","ror":"https://ror.org/02cv4ah81","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210119324"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Shigenori Wakita","raw_affiliation_strings":["Department of Medical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Medical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan","institution_ids":["https://openalex.org/I4210119324"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5124019583","display_name":"Hiroshi Yoshino","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210119324","display_name":"Ishikawa Prefectural Central Hospital","ror":"https://ror.org/02cv4ah81","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210119324"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Hiroshi Yoshino","raw_affiliation_strings":["Department of Breast surgery, Ishikawa Prefectural Central Hospital, 2-1, KuratsukiHigashi , Kanazawa, Ishikawa, 920-8530, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Breast surgery, Ishikawa Prefectural Central Hospital, 2-1, KuratsukiHigashi , Kanazawa, Ishikawa, 920-8530, Japan","institution_ids":["https://openalex.org/I4210119324"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I4210119324"],"apc_list":{"value":3390,"currency":"USD","value_usd":3390},"apc_paid":{"value":3390,"currency":"USD","value_usd":3390},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10769","display_name":"BRCA gene mutations in cancer","score":1.0,"subfield":{"id":"https://openalex.org/subfields/1311","display_name":"Genetics"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T10769","display_name":"BRCA gene mutations in cancer","score":1.0,"subfield":{"id":"https://openalex.org/subfields/1311","display_name":"Genetics"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T14078","display_name":"Multiple and Secondary Primary Cancers","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11134","display_name":"Breast Lesions and Carcinomas","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/brca-genetic-testing","display_name":"BRCA genetic testing","score":0.8450000286102295},{"id":"https://openalex.org/keywords/hereditary-breast-and-ovarian-cancer-syndrome","display_name":"hereditary breast and ovarian cancer","score":0.9350000023841858},{"id":"https://openalex.org/keywords/insurance-coverage-expansion","display_name":"insurance coverage expansion","score":0.8339999914169312},{"id":"https://openalex.org/keywords/risk-reducing-mastectomy","display_name":"prophylactic mastectomy","score":0.8500000238418579},{"id":"https://openalex.org/keywords/risk-reducing-salpingo-oophorectomy","display_name":"risk-reducing salpingo-oophorectomy","score":0.9850000143051147},{"id":"https://openalex.org/keywords/secondary-malignancies","display_name":"secondary malignancies","score":0.9729999899864197},{"id":"https://openalex.org/keywords/ductal-carcinoma-in-situ","display_name":"ductal carcinoma in situ","score":0.921999990940094},{"id":"https://openalex.org/keywords/nonpalpable-breast-lesions","display_name":"nonpalpable breast lesions","score":0.8379999995231628},{"id":"https://openalex.org/keywords/prophylactic-surgery","display_name":"prophylactic surgery","score":0.4259999990463257},{"id":"https://openalex.org/keywords/japan","display_name":"Japan","score":0.609000027179718}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9002000093460083},{"id":"https://openalex.org/C2780673598","wikidata":"https://www.wikidata.org/wiki/Q285223","display_name":"Genetic testing","level":2,"score":0.7408999800682068},{"id":"https://openalex.org/C530470458","wikidata":"https://www.wikidata.org/wiki/Q128581","display_name":"Breast cancer","level":3,"score":0.6653000116348267},{"id":"https://openalex.org/C2780140570","wikidata":"https://www.wikidata.org/wiki/Q3545481","display_name":"Surgical oncology","level":2,"score":0.6233000159263611},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.5194000005722046},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.5192999839782715},{"id":"https://openalex.org/C2910039337","wikidata":"https://www.wikidata.org/wiki/Q16394661","display_name":"Prophylactic Mastectomy","level":5,"score":0.5116000175476074},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.48030000925064087},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.4595000147819519},{"id":"https://openalex.org/C520017518","wikidata":"https://www.wikidata.org/wiki/Q178934","display_name":"Occult","level":3,"score":0.4117000102996826},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.41100001335144043},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.4027999937534332},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.4023999869823456},{"id":"https://openalex.org/C2780427987","wikidata":"https://www.wikidata.org/wiki/Q172341","display_name":"Ovarian cancer","level":3,"score":0.3959999978542328},{"id":"https://openalex.org/C29456083","wikidata":"https://www.wikidata.org/wiki/Q1221899","display_name":"Gynecology","level":1,"score":0.39169999957084656},{"id":"https://openalex.org/C2781179581","wikidata":"https://www.wikidata.org/wiki/Q2857712","display_name":"Family history","level":2,"score":0.37290000915527344},{"id":"https://openalex.org/C80227256","wikidata":"https://www.wikidata.org/wiki/Q1124169","display_name":"Genetic counseling","level":2,"score":0.3619999885559082},{"id":"https://openalex.org/C2777757722","wikidata":"https://www.wikidata.org/wiki/Q848318","display_name":"Mastectomy","level":4,"score":0.3522999882698059},{"id":"https://openalex.org/C2780862961","wikidata":"https://www.wikidata.org/wiki/Q5311598","display_name":"Ductal carcinoma","level":4,"score":0.3400999903678894},{"id":"https://openalex.org/C2780194787","wikidata":"https://www.wikidata.org/wiki/Q4836333","display_name":"BRCA mutation","level":4,"score":0.30809998512268066},{"id":"https://openalex.org/C50382708","wikidata":"https://www.wikidata.org/wiki/Q223218","display_name":"Proportional hazards model","level":2,"score":0.26739999651908875},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.2639999985694885},{"id":"https://openalex.org/C2780234812","wikidata":"https://www.wikidata.org/wiki/Q1787013","display_name":"Cancer prevention","level":3,"score":0.2614000141620636},{"id":"https://openalex.org/C131872663","wikidata":"https://www.wikidata.org/wiki/Q5284418","display_name":"Obstetrics","level":1,"score":0.2581000030040741},{"id":"https://openalex.org/C2778527826","wikidata":"https://www.wikidata.org/wiki/Q1787017","display_name":"Cancer registry","level":3,"score":0.25609999895095825},{"id":"https://openalex.org/C146357865","wikidata":"https://www.wikidata.org/wiki/Q1123245","display_name":"Stage (stratigraphy)","level":2,"score":0.25429999828338623}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12885-026-16878-3","doi":"https://doi.org/10.1186/s12885-026-16878-3","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12885-026-16878-3","pdf_url":null,"source":{"id":"https://openalex.org/S192926780","display_name":"BMC Cancer","issn_l":"1471-2407","issn":["1471-2407"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Cancer","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12885-026-16878-3","doi":"https://doi.org/10.1186/s12885-026-16878-3","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12885-026-16878-3","pdf_url":null,"source":{"id":"https://openalex.org/S192926780","display_name":"BMC Cancer","issn_l":"1471-2407","issn":["1471-2407"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Cancer","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4213227311","https://openalex.org/W4389822923","https://openalex.org/W4416266899","https://openalex.org/W7159979994","https://openalex.org/W2094961820","https://openalex.org/W4388630185","https://openalex.org/W4411291184","https://openalex.org/W4410096189","https://openalex.org/W4417035786","https://openalex.org/W4317434637"],"abstract_inverted_index":{"Abstract":[0],"Purpose":[1],"Timely":[2],"identification":[3,251],"of":[4,69,81,92,135,142,161,193,205,226,233,252,273],"hereditary":[5,253],"breast":[6,48,103,215],"and":[7,77,126,139,146,209],"ovarian":[8],"cancer":[9,49,104,115,169,254],"(HBOC)":[10],"is":[11],"essential":[12],"for":[13,25,101,289],"preventive":[14,290],"strategies":[15,291],"such":[16],"as":[17],"risk-reducing":[18,82,143,147],"surgery.":[19,83],"In":[20],"Japan,":[21],"national":[22,162],"insurance":[23,163,234],"coverage":[24,131,235],"BRCA":[26,52,246],"genetic":[27,53,75,118,172,198,247,267,279],"testing":[28,54,76,119,173],"was":[29,120,201,236],"expanded":[30],"in":[31,109,189,203,211,220,224,242,292],"April":[32,129],"2020.":[33],"This":[34],"study":[35,91],"primarily":[36],"aimed":[37],"to":[38,51,74,117,171,179,245,266,278],"determine":[39],"whether":[40],"this":[41,257],"policy":[42,258],"change":[43],"shortened":[44],"the":[45,67,78,128,140,159,165,243,270],"interval":[46,112,167],"from":[47,113,168,176],"diagnosis":[50,116,170],"among":[55],"patients":[56,93,123,155,207],"with":[57,94,238,282],"pathogenic":[58,95],"BRCA1/2":[59,96],"variants.":[60],"As":[61],"supportive":[62],"analyses,":[63],"we":[64],"also":[65,151],"examined":[66],"timing":[68],"second":[70,136,260],"primary":[71,102,137,186,261],"cancers":[72,138,187,262],"relative":[73],"subsequent":[79],"uptake":[80,141],"Methods":[84],"We":[85],"conducted":[86],"a":[87,106,239],"retrospective":[88],"single-center":[89],"cohort":[90],"variants":[97],"who":[98],"underwent":[99],"surgery":[100],"at":[105],"single":[107],"institution":[108],"Japan.":[110],"The":[111,133],"initial":[114],"compared":[121],"between":[122],"diagnosed":[124],"before":[125,197],"after":[127],"2020":[130],"expansion.":[132],"occurrence":[134],"mastectomy":[144],"(RRM)":[145],"salpingo-oophorectomy":[148],"(RRSO)":[149],"were":[150,156,222],"analyzed.":[152],"Results":[153],"Thirty":[154],"included.":[157],"Following":[158],"expansion":[160],"coverage,":[164],"median":[166],"decreased":[174],"significantly,":[175],"2158":[177],"days":[178,181],"54":[180],"(p":[182],"<":[183],"0.001).":[184],"Second":[185],"occurred":[188,264],"10":[190],"patients,":[191],"most":[192],"which":[194],"(8/10)":[195],"developed":[196],"testing.":[199,275],"RRM":[200,228],"performed":[202],"76.0%":[204],"eligible":[206],"(19/25),":[208],"RRSO":[210],"48.1%":[212],"(13/27);":[213],"occult":[214],"lesions,":[216],"both":[217],"ductal":[218],"carcinoma":[219],"situ,":[221],"identified":[223],"2":[225],"19":[227],"specimens":[229],"(10.5%).":[230],"Conclusion":[231],"Expansion":[232],"associated":[237],"marked":[240],"reduction":[241],"time":[244],"testing,":[248,268,280],"enabling":[249],"earlier":[250],"risk.":[255],"Before":[256],"change,":[259],"frequently":[263],"prior":[265],"underscoring":[269],"clinical":[271],"consequences":[272],"delayed":[274],"Earlier":[276],"access":[277],"together":[281],"multidisciplinary":[283],"counseling,":[284],"may":[285],"help":[286],"expand":[287],"opportunities":[288],"HBOC.":[293]},"counts_by_year":[],"updated_date":"2026-11-13T13:42:25.865203","created_date":"2026-08-30T00:00:00"}