Macdonald AS, Waters HR, Wekwete CT. The genetics of breast and ovarian cancer I: a model of family history. Scand. Actuarial J. 2003; 1: 1-27. We present a Markov model of breast cancer (BC) and ovarian cancer (OC) and estimate its transition intensities, mainly using United Kingdom population data. In the case of BC and OC, we estimate intensities according to BRCA1 and BRCA2 genotype. We use this to estimate the probabilities that an applicant for insurance has a BRCA1 or BRCA2 mutation,

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... n complete or incomplete knowledge of her family history of BC and OC. Life (and other) insurance underwriters typically have incomplete knowledge of family history, for example no information on the number of healthy relatives. We show how these probabilities depend strongly on estimates of the mutation frequencies and penetrances, and conclude that it may not be appropriate to apply risk estimates based on studies of high-risk families to other groups.