Family cancer histories prove challenging

Identifying individuals with inherited mutations conferring high risks of cancer before they develop tumours may be our best strategy for cancer prevention. But in a special symposium yesterday exploring how medical oncologists are dealing with the new wave of genetic information, Dr Ephrat Levy Lahad from Shaare Zedek Medical Center, Jerusalem, Israel, advised that real challenges exist for the widespread implementation of such approaches.

Currently, carriers are most often identified after they have been diagnosed with cancer, or through a family history of cancer. The utilization of family history, however, is limited by a lack of communication both about cancer diagnoses and the results of genetic testing.

Dr Levy Lahad presented data from his recent study on BRCA1/ BRCA2 testing that he had undertaken in the general Ashkenazi (European) Jewish population. Two mutations in BRCA1 and one in BRACA2 are common in the Ashkenazi Jewish population, placing them at increased risk of ovarian and breast cancer. Findings from his study revealed that half of the families included did not possess sufficient information on their family histories, suggesting that many carriers of BRCA1/ BRCA2 mutations could not be readily identified without the implementation of a general screening programme. However, Dr Levy-Lahad warned that there are both technical and ethical challenges to such an approach.