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Genetic Testing for Inherited Cancer Risk Remains Underused in U.S.
About 10% of cancers diagnosed in the U.S. are thought to come from inherited genetic mutations that increase cancer risk. Yet most people with inherited genetic mutations have no idea their risk is higher, so they don’t take steps like getting more frequent cancer screenings or even undergoing preventive surgeries that can reduce their risk of getting cancer or catch it when treatment has a better chance of success. Experts say a simple and inexpensive blood test can check dozens of genes associated with different kinds of cancers, including breast, ovarian, colon, pancreatic, stomach, prostate and more, but most people who should be offered this kind of screening never hear about it. “It’s an amazing scientific advance. And it’s a shame that it’s not being used as widely as it could be to realize its full impact,” said gastroenterologist Sapna Syngal of the Dana-Farber Cancer Institute in Boston in a report on NPR. According to the Aug. 2 NPR story, the latest guidelines recommend genetic testing for everyone diagnosed with ovarian cancer, pancreatic cancer, metastatic prostate cancer and male breast cancer. Doctors should also consider testing anyone with colon or breast cancer. Testing and finding inherited risk in patients who already have cancer can alert their family members that they should get tested too. Yet according to a recent study, only 6.8% of more than a million people diagnosed with cancer in California and Georgia were tested for inheritable genetic mutations linked to cancer. Experts say reasons could include doctors not being aware of recent research into inherited cancer risk or how the cost of testing has come down in recent years. Also many patients may not be aware of a history of cancer in their family due to stigma in previous generations that left many reluctant to share their diagnosis.
Trying to Understand Racial Disparities in Breast and Prostate Cancer
Researchers seeking to understand why Black men and women are at higher risk of developing and dying from aggressive breast and prostate cancer have established the African Cancer Genome Registry to study the problem globally. According to an Aug. 1 story on STAT, about 500 breast and prostate cancer survivors from the U.S. and five Caribbean nations have been enrolled in the registry so far, with plans to expand enrollment to four African countries. Breast cancer researcher Sophia George of the Sylvester Comprehensive Cancer Center of the University of Miami Health System said the goal is to register tens of thousands of participants. In the U.S., Black women are 41% more likely to die of breast cancer than white women, and prostate cancer is the second-leading cause of cancer death for Black men in the U.S. Breast and prostate cancer are also leading causes of death in the Caribbean and in Africa. George said the reasons for these numbers are not well understood, underscoring the need for the registry. “First of all we’ve been under-studied for so long, chronically,” said George. “And now there is a movement afoot to be more intentional about studying populations that experience higher burden of disease.” George and her colleagues will analyze where people are born, possible inherited genetic mutations, and lifestyle factors such as diet and body weight to understand the causes of increased risk.
Warnings on Individual Cigarettes Coming to Canada
Cigarettes sold in Canada will soon have warnings printed on every cigarette, not just on packaging, according to a report on the Canadian Broadcasting Corp. website. New regulations took effect Aug. 1 that will phase in warnings for cigarettes and small cigars between July 2024 and April 2025. The wording will appear in English and French and feature warnings about harming children, damaging organs, and causing impotence and leukemia. One planned warning is “Poison in every puff.” “For youth who experiment by ‘borrowing’ a cigarette from a friend, it’s going to mean they will see the cigarettes—even if they may not see the package—where the warnings appear,” said Rob Cunningham, a senior policy analyst at the Canadian Cancer Society. Cunningham says dozens of studies have shown the effectiveness of printed warnings on cigarettes in reducing tobacco use. Organizations funded by the tobacco industry oppose the measure, claiming it will drive cigarette smokers to purchase contraband cigarettes and channel money to organized crime. But according to Cunningham, “The only real reason that they can oppose something is because it’s going to have a reduction in sales—and that is exactly the point.” Canada was the first country to require tobacco manufacturers to print pictorial warnings on cigarette packs and include health promoting messages in package inserts. Since then, more than 130 countries have enacted similar measures, according to the Canadian Cancer Society.
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