Regional Health April 16, 2018

Heredity refers to the genetic passing down of physical or mental characteristics from one generation to another. Traits ranging from eye color to height to personality type are thought to be inherited. Sometimes, genetic mutations, or changes in specific cell DNA, also are inherited from parent(s). These genes exist in virtually all the cells of your body, and may allow some cancers and related diseases to develop. In particular, some people have a greater genetic predisposition toward some gynecological cancers and other conditions that are related to the female reproductive organs. These include:

 

  • Breast Cancer
  • Ovarian Cancer
  • Uterine (Endometrial) Cancer
  • Familial Adenomatous Polyposis (FAP), a precursor to colon and rectal cancers

 Identifying Cancer Risk

Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue called a tumor forms. The term cancer refers to malignant tumors, which can invade nearby tissues and spread to other parts of the body. A benign tumor does not invade or spread.

In general, cancer is not considered an inherited disease because the majority of cancers occur in people with no significant family history of cancer. The presence of a particular genetic mutation linked to cancer does not guarantee that you will get that cancer, but it can substantially increase your risk. The American College of Obstetricians and Gynecologists® (ACOG)1 states that a hereditary cancer risk assessment should be performed to:

 

  • Identify patients and families who may be at increased risk of developing certain types of cancer. This assessment should be performed by obstetrician–gynecologists or other obstetric–gynecologic providers and should be updated regularly. 

 

  • Refer those who are identified at increased risk to a specialist in cancer genetics or a health care provider with expertise in genetics. After gathering additional family history information, risk assessment, education, and counseling, genetic testing may be recommended.

 

Inherited Gynecological Disorders

Diseases or disorders related to the female reproductive system that are at a higher risk of being genetically inherited include:

 

  1. Breast Cancer

Only about 15% of women with breast cancer have a family history of breast cancer. The risk is determined by how close the relations are and how many family members have breast cancer. For example, one first-degree relative such as a parent, sibling, or child with breast cancer can double an individual's risk of breast cancer. If there are two first-degree relatives with breast cancer, then an individual's risk is 3 times higher than average. Having one second-degree relatives such as aunts, nieces, or grandparents with breast cancer does not increase an individual's risk of breast cancer. Having 2 second-degree relatives with breast cancer does increase risk, though. Having male relatives with breast cancer also increases the risk of developing breast cancer, but the risk levels are not as clear. 

 

  1. Ovarian Cancer

According to the CDC2, “Each year in the United States, about 21,000 women get ovarian cancer and about 14,000 die from it. It causes more deaths than any other cancer of the female reproductive system, even thought it accounts for only about 3% of all cancers in women.”

Ovarian cancer tends to run in families. This is especially true for first-degree relatives like a sister, daughter, or mother. Having other cancers in your family including colon, rectal, or breast cancers, also increases your risk of ovarian cancer. ACOG research shows that “Women with hereditary breast and ovarian cancer syndrome have a 65–74% lifetime risk of breast cancer and a 39–46% (BRCA1) or a 12–20% (BRCA2) risk of ovarian cancer.”1

 

 

  1. Uterine (Endometrial) Cancer

The risk of developing uterine cancer increases with age, and is most often found in women who already have gone through menopause. More than 50,000 women are diagnosed with uterine cancer every year in the United States. It is the most gynecologic cancer that is diagnosed most often.

 

Lynch syndrome also is a rare, hereditary condition in which many family members develop colorectal and other cancers. The lifetime risk of developing uterine cancer is close to 50% in women with a personal or family history of Lynch syndrome. The presence of Lynch syndrome also increases the lifetime risk of colon cancer (52–82%), endometrial cancer (25–60%), and ovarian cancer (4–24%).1

  1. Familial Adenomatous Polyposis (FAP)

Familial adenomatous polyposis (FAP) is a rare, inherited condition that can lead to colon and rectal cancer. FAP results in the development of hundreds of polyps inside the large intestine.

 

Genetic Testing

Families with a high risk of gynecological cancers or related diseases may consider genetic testing to determine if known genetic factors are causing the increased risk. Genetic mutations are changes in cellular DNA that allow cancer to develop and grow. The 2 most common genetic mutations occur in BRCA1 and BRCA2 genes, and are linked to the largest increase in lifetime risk of developing cancer.

Women with the BRCA1 or BRCA2 genes are at a higher risk for:

 

  • Breast cancer at an earlier age
  • Breast cancer in both breasts
  • Ovarian cancer

 

The Centers for Disease Control and Prevention (CDC)2 states that you may be at higher risk if you have:

 

  • Several relatives with breast cancer.
  • Any relatives with ovarian cancer.
  • Relatives who got breast cancer before age 50.
  • A relative with cancer in both breasts.
  • A relative who had both breast and ovarian cancers.
  • A male relative with breast cancer.
  • Ashkenazi Jewish ancestry (Central or Eastern European) and any relative with breast or ovarian cancer.
  • A relative with a known BRCA gene mutation.

 

To help women track symptoms that may be related to a gynecological cancer, the CDC created a Gynecologic Cancer Symptoms Diary. This may be especially helpful tool for any woman, whether she has a genetic predisposition to gynecological cancers or not.

 

Sources:

1American College of Obstetricians and Gynecologists® (ACOG): www.acog.org 

2Centers for Disease Control and Prevention (CDC): www.cdc.gov 

3Centers for Disease Control and Prevention (CDC): www.cdc.gov/symptomsdiary

If you are exhibiting any of the symptoms references, please consult your physician. Dr. Stanley Drake, with Regional Health Ob/Gyn can help with diagnosis and treatment. To schedule an appointment call the office at (812) 232-6613 or click below to book an appointment online.

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