About 1 in 400 people in the general population carries a harmful BRCA1 or BRCA2 mutation, which works out to roughly 0.2% to 0.3%. That number is small, but it rises sharply in certain ethnic groups and accounts for a meaningful share of breast and ovarian cancers overall. About 3% of all breast cancers and 10% of all ovarian cancers are caused by inherited BRCA mutations.
General Population Prevalence
Everyone has two BRCA genes (BRCA1 and BRCA2). These genes help repair damaged DNA in your cells, so when one carries a harmful mutation, that repair system doesn’t work properly and cancer risk climbs. The 1-in-400 figure refers to people who inherited a broken version of one of these genes from a parent. You only need one mutated copy to have elevated risk.
Because the mutation is inherited, it runs in families. If one of your parents carries it, you have a 50% chance of inheriting it yourself. Men and women carry BRCA mutations at the same rate, even though the conversation often centers on women’s cancers.
Higher Rates in Certain Ethnic Groups
People of Ashkenazi Jewish descent (Central or Eastern European Jewish ancestry) have a dramatically higher carrier rate: about 1 in 40, which is roughly five times the general population rate. Three specific mutations in BRCA1 and BRCA2 are especially common in this group, likely because they were passed down through a relatively small founding population.
Research on racial differences in the U.S. has also found some variation. A large population-based study of women with breast cancer found that BRCA1 mutations were more common among White women (2.9%) than Black women (1.4%), while BRCA2 mutations were slightly more frequent in Black women (2.6%) compared to White women (2.1%). Less data exists for Hispanic and Asian populations, though carrier rates in those groups are generally thought to be similar to the overall population average.
What These Mutations Mean for Cancer Risk
Carrying a BRCA mutation doesn’t guarantee cancer, but it raises lifetime risk substantially compared to the general population. Women with a BRCA1 mutation face the highest breast cancer risk, with estimates ranging from about 55% to 72% by age 70 to 80. BRCA2 carriers have a somewhat lower but still elevated risk, generally in the range of 45% to 69%. For context, the average woman’s lifetime breast cancer risk is about 13%.
Ovarian cancer risk also rises considerably. BRCA1 carriers face a lifetime ovarian cancer risk of roughly 39% to 44%, while BRCA2 carriers face about 11% to 17%. The average woman’s lifetime risk of ovarian cancer is just over 1%, so these numbers represent a dramatic increase.
BRCA mutations also raise risk for cancers that get less attention. Men with BRCA2 mutations have a notably higher risk of prostate cancer, and current guidelines recommend annual screening starting at age 40 for male BRCA2 carriers. Pancreatic cancer risk is elevated too, particularly with BRCA2 mutations, and screening may be recommended starting at age 50 or earlier if there’s a family history.
How BRCA Mutations Are Found
BRCA testing is a blood or saliva test that sequences both genes looking for harmful variants. It’s typically recommended based on personal or family cancer history rather than offered to everyone. Factors that point toward testing include a breast cancer diagnosis before age 45, ovarian cancer at any age, multiple breast cancers in close relatives, male breast cancer in the family, or Ashkenazi Jewish ancestry.
The test itself is straightforward. The question for most people is whether it will be covered by insurance.
Cost and Insurance Coverage
Most health insurance plans cover BRCA testing when a physician recommends it. Under the Affordable Care Act, women at increased risk are entitled to genetic counseling and BRCA testing with no copay. This is one of the few genetic tests with that level of required coverage.
Medicare covers BRCA testing under specific conditions: a personal history of breast cancer diagnosed before 45, ovarian cancer, male breast cancer, a known BRCA mutation in a close relative, or Ashkenazi Jewish ethnicity (with no additional family history requirement). Medicaid coverage varies by state. Some state programs cover BRCA testing, but the rules differ significantly depending on where you live.
If you don’t meet insurance criteria, out-of-pocket costs for BRCA testing have dropped considerably over the past decade. Several commercial labs now offer panel testing for a few hundred dollars or less, though prices vary.
Why the Numbers Matter
A 1-in-400 carrier rate might sound rare, but applied to a country of 330 million people, it means roughly 800,000 or more Americans carry a harmful BRCA mutation. Many don’t know it. Studies consistently show that a large share of carriers are unaware of their status, particularly in families where cancer appeared on the father’s side (since BRCA-related cancers in men are less common and less recognized) or in families that are small, making patterns harder to spot.
Knowing your carrier status matters because it opens the door to earlier and more intensive screening, risk-reducing medications, and in some cases preventive surgery, all of which have been shown to significantly reduce cancer incidence and death in BRCA carriers. If your family history includes early-onset breast cancer, ovarian cancer, or multiple cancer diagnoses across generations, that pattern is worth discussing with a healthcare provider who can evaluate whether genetic testing makes sense for you.