Greater awareness of increased breast and ovarian cancer risk in women with paternal family history could save lives

October 24, 2010

Individuals with an inherited BRCA1 or BRCA2 gene mutation are at increased risk of cancer, particularly of breast and ovarian cancer. Yet despite both men and women being equally likely to pass this genetic susceptibility to their children, a father's family history is not well recognised as a risk factor. As a result, women who might have inherited the mutated gene from their father could be missing out on opportunities for genetic testing and early diagnosis. These are the conclusions of a Comment published Online First in The Lancet Oncology.

About 5% of breast and ovarian cancer cases are the result of an inherited genetic predisposition mostly caused by the BRCA1 or BRCA2 genes. These gene mutations increase the risk of cancers in both men and women, but women in particular face an increased lifetime risk of breast cancer (55󈟃%) and ovarian cancer (20󈞘%). However, men and women with this genetic predisposition have the same risk (50%) of passing it to each of their children.

According to Jeanna McCuaig from the Princess Margaret Hospital, Toronto, Canada and colleagues, most health-care providers know of the increased breast and ovarian cancer risk in women with this gene mutation, but "many remain unaware that these women might have inherited the mutated gene from their father...and might not routinely collect this information from their patients." Moreover, a history of cancer on the father's side may not be as well reported by patients because they do not know it is a risk factor for cancer.

The authors point out that "deficits in knowledge among health-care providers and the general population about the inheritance patterns of BRCA1 and BRCA2 gene mutations could result in missed opportunities for genetic testing and cancer prevention in individuals with a paternal family history."

To further investigate whether such a discrepancy exists, the authors used patient records from their clinic in Toronto, Canada, to compare the number of patients referred with maternal and paternal family history of breast or ovarian cancer. They found that patients with a maternal family history of cancer were 5 times more likely to be referred.

These findings, say the authors, emphasise the importance of health-care providers reviewing and assessing a patient's maternal and paternal family histories equally.

They conclude: "With an increased awareness by health-care providers of the potential paternal transmission of BRCA1 and BRCA2 gene mutations, together with their ability to provide accurate risk assessments, fewer opportunities for cancer prevention will be missed."
Jeanna McCuaig, Princess Margaret Hospital, Toronto, Canada. T) +1 416 946 2286 E)

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