ACOG Committee Stresses on Hereditary Cancer Risk Assessment

According to the American College of Obstetricians and Gynecologists’ (ACOG) committee, obstetrician-gynecologists should perform a hereditary cancer risk assessment, and the assessment should be updated at regular intervals. This is especially with regards to breast cancer, ovarian cancer, and endometrial cancer which are often a part of hereditary cancer syndromes. A hereditary cancer syndrome is a genetic predisposition to cancer due to inherited gene mutations. About 5-10% of all cancers are hereditary. Individuals and families who may be at high risk of developing certain types of cancer can be recognized using a hereditary cancer risk assessment.

The committee suggests that the screening must at least consider, a personal cancer history, and a first and second-degree relative cancer history. The following information should be obtained regarding family members:

• Cancer history of first-degree relatives including siblings, parents, children
• Cancer history of second-degree relatives including half-siblings, nephews, nieces, grandchildren, uncles, aunts and grandparents
• Cancer history of maternal and paternal sides
• History of European Jewish ancestry
• The type of primary cancer and age at cancer diagnosis for each cancer case
• Outcomes of any cancer predisposition test in any relative

Hints that the hereditary cancer syndrome may be present include:

• Unusually young age of diagnosis of cancer
• Same person suffers from several different types of cancer
• A single individual suffers from multiple primary tumors in the same organ such as breast or colon
• Many close blood relatives with the same type of cancer
• Rarer kind of presentation of cancer like breast cancer in a man
• The presence of birth defects that are known to be related to hereditary cancer syndromes
• Being of Ashkenazi Jewish ancestry. Individuals of Ashkenazi Jewish descent have Jewish relatives who originate from Eastern or Central Europe. They often have BRCA mutations, which could increase their risk for cancers like breast and ovarian cancer
• Occurrence of some cancers in adults like triple-negative breast cancer in which the probability of harboring a hereditary cancer syndrome is high

The ACOG committee recommends a referral to a specialist in cancer genetics or a health care provider who is an expert in genetics if the assessment suggests a high risk for hereditary cancer syndrome.

Reference:

http://journals.lww.com/greenjournal/Fulltext/2015/06000/Committee_Opinion_No__634___Hereditary_Cancer.57.aspx?WT.mc_id=HPxADx20100319xMP#P37

Source-Medindia