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Background  Identifying female carriers of  BRCA1  and  BRCA2  mutations is imperative for prevention of ovarian cancer and breast cancer. There are five major histologic subtypes of ovarian cancer and high grade serous cancer (the most common) is reported in 75–100% of  BRCA1  and  BRCA2  mutation carriers. We examined histology-based referral to the Hereditary Cancer Program following an educational prevention campaign recommending  BRCA1  and  BRCA2  mutation screening for all high-grade serous cancer patients.    Methods  We conducted a population-based retrospective study in the province of British Columbia, Canada that included all patients visiting the Hereditary Cancer Program for genetic counselling for  BRCA1  and  BRCA2  mutation between 2001 and 2014. We examined the difference in rates of  BRCA1  and  BRCA2  testing between serous cancer patients and endometrioid and clear cell cancer patients using a differences in differences analysis. We also calculated the mean number of family members tested for every  BRCA1  and  BRCA2  identified ovarian cancer patient before and after the educational campaign.    Results  There were 5712 women tested for a  BRCA1  and  BRCA2  mutation at the HCP between 2001 and 2014, 887 of which had previously received a diagnosis of ovarian cancer. By 2013, 43% of serous cancer patients were being tested for  BRCA1  and  BRCA2  mutations compared with 20% of endometrioid and clear cell patients ( p  &lt; 0.001). The mean number of family members tested for each  BRCA1  and  BRCA2  positive ovarian cancer patient increased after the educational campaign from 2.54 to 3.27 ( p  = 0.071), and the number of family members identified as BRCA positive also increased significantly.    Conclusions  Recommendations for histology-based referral significantly increased the likelihood of serous cancer patients being tested for BRCA mutations. There was also an increase in the number of carrier tests performed for each  BRCA1  and  BRCA2  index ovarian cancer patient.    Electronic supplementary material  The online version of this article (10.1186/s12885-018-4153-8) contains supplementary material, which is available to authorized users.

bmc cancer

A population-based analysis of germline BRCA1 and BRCA2 testing among ovarian cancer patients in an era of histotype-specific approaches to ovarian cancer prevention