Genetic cancer testing can have a dramatic impact for high risk individuals

Contributing columnistMay 5, 2014 

Legendary University of North Carolina basketball coach Dean Smith once said, "There is a point in every contest when sitting on the sidelines is not an option."

Many people who have a family history of cancer no longer want to "sit on the sidelines" and, instead, want to be tested to see whether they might be genetically predisposed to cancer. But genetic testing isn't recommended for everyone.

The Society of Gynecol ogic Oncology recently released clinical practice statements that assist physicians and other health care professionals to determine who might benefit from genetic testing regarding ovarian and endometrial cancers.

Ovarian cancer, which includes cancers of the fallopian tube, ovary and peritoneum, will affect an estimated 21,980 women in the United States in 2014. It is thought that 15 percent of ovarian cancers have a relationship to BRCA, a gene important in the repair of damaged genetic material known as DNA.

Depending on the type of BRCA genetic change, a woman with BRCA has a five times increased risk of breast cancer and 10 times increased risk of ovarian cancer compared to a woman without BRCA. Men can be BRCA carriers and can develop related cancers such as breast cancer and prostate cancer. It is important to remember that the vast majority of breast and ovarian cancers have no genetic link. That's why only high-risk individuals undergo genetic counseling, testing or both.

Endometrial cancers are cancers of the lining of the uterus, also known as the womb. In 2010, endometrial cancer was the fourth most common cancer in women. The main controllable risk factor for endometrial cancer is being overweight/obese.

Individuals with a family history of colorectal cancer, especially in a family member younger than 50, might have a genetic predisposition to endometrial cancer called Lynch syndrome. Individuals with Lynch syndrome have a 40 percent to 60 percent lifetime risk for colon and endometrial cancer. Ovarian, kidney and other cancers also can be related to this genetic predisposition.

Baptist Health Lexington began screening for Lynch syndrome five years ago by doing a special test on all colon and endometrial cancers in individuals younger than 60. This has helped identify several individuals and their family members affected with Lynch syndrome.

Most people don't have an increased risk of cancer due to a genetic predisposition. Those for whom genetic testing is recommended will find that it can have a dramatic effect on their health and the health of their family members.

Dr. Hope Cottrill is a gynecologic oncologist with Baptist GYN Oncology Services at Baptist Health Lexington.

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