A recent article sought to develop an approach to cancer risk management among individuals with mutations in newer inherited cancer genes, many of which result in a moderate (rather than ‘high’) cancer risk. Overall, the investigators suggest a framework that takes the age-specific, lifetime, and absolute cancer risks into account for inherited cancer genes where there is a proven association with cancer predisposition based on published data. They then suggest that cancer risk management should be initiated in women with pathogenic mutations in these inherited genes at the age when their 5-year cancer risk would approach that at which screening would routinely be initiated in women in the general population (which in the U.S. is approximately 1% for breast cancer). Given the lack of data on many of these newer genes to inform best surveillance strategies, investigators offer management suggestions with the hope of providing assistance to clinicians in managing patients as more definitive data emerges. The need to collect data among those with mutations in these newer genes (such as ATM, CHEK2, NBN, PALB2, BRIP1, RAD51C, and RAD51D) highlights the importance of participating in research registry efforts such as ICARE.
Tung N, et al. Nat Rev Clin Oncol. 2016 Jun 14. PMID: 27296296.