BRCA1, BRCA2, and Associated Cancer Risks and Management for Male Patients

Link: https://jamanetwork.com/journals/jamaoncology/article-abstract/2821594

Excerpt:

Importance  Half of all carriers of inherited cancer-predisposing variants in BRCA1 and BRCA2 are male, but the implications for their health are underrecognized compared to female individuals. Germline variants in BRCA1 and BRCA2 (also known as pathogenic or likely pathogenic variants, referred to here as BRCA1/2 PVs) are well known to significantly increase the risk of breast and ovarian cancers in female carriers, and knowledge of BRCA1/2 PVs informs established cancer screening and options for risk reduction. While risks to male carriers of BRCA1/2 PVs are less characterized, there is convincing evidence of increased risk for prostate cancer, pancreatic cancer, and breast cancer in males. There has also been a rapid expansion of US Food and Drug Administration–approved targeted cancer therapies, including poly ADP ribose polymerase (PARP) inhibitors, for breast, pancreatic, and prostate cancers associated with BRCA1/2 PVs.

Observations  This narrative review summarized the data that inform cancer risks, targeted cancer therapy options, and guidelines for early cancer detection. It also highlighted areas of emerging research and clinical trial opportunities for male BRCA1/2 PV carriers. These developments, along with the continued relevance to family cancer risk and reproductive options, have informed changes to guideline recommendations for genetic testing and strengthened the case for increased genetic testing for males.

Conclusions and Relevance  Despite increasing clinical actionability for male carriers of BRCA1/2 PVs, far fewer males than female individuals undergo cancer genetic testing. Oncologists, internists, and primary care clinicians should be vigilant about offering appropriate genetic testing to males. Identifying more male carriers of BRCA1/2 PVs will maximize opportunities for cancer early detection, targeted risk management, and cancer treatment for males, along with facilitating opportunities for risk reduction and prevention in their family members, thereby decreasing the burden of hereditary cancer.

Author(s): Heather H. Cheng, MD, PhD1,2Jeffrey W. Shevach, MD3Elena Castro, MD, PhD4et al

JAMA Oncol. 2024;10(9):1272-1281.

doi:10.1001/jamaoncol.2024.2185

Publication Date: July 25, 2024

Publication Site: JAMA Oncology

The Latest Research on Why So Many Young Adults Are Getting Cancer

Link: https://www.mskcc.org/news/why-is-cancer-rising-among-young-adults

Graphic:

MSK breast oncologist Dr. Shari Goldfarb

Excerpt:

Men and women in the prime of their lives are increasingly being diagnosed with serious cancers, including colorectalbreastprostateuterinestomach (gastric)pancreatic, and more. One forecast predicts cancer for this age group will increase by 30% globally from 2019 to 2030.

“This is serious and worrisome,” says Shari Goldfarb, MD, breast oncologist and Director of MSK’s Young Women With Breast Cancer program.   

“This is not a blip,” explains Andrea Cercek, MD, gastrointestinal oncologist and Co-Director of The Center for Young Onset Colorectal and Gastrointestinal Cancer. “The more data we gather, the clearer this becomes.”

MSK is a pioneer in caring for the specific needs of people facing what are often called early-onset cancers, who confront very different challenges than older adults. The coming surge in cases is a key reason MSK is building a new state-of-the-art hospital, called the MSK Pavilion.

Just as importantly, MSK experts are leading the investigation into why this is happening.

Author(s): Bill Piersol

Publication Date: 3 Sept 2024

Publication Site: Memorial Sloan Kettering News

Annual Report to the Nation on the Status of Cancer, Part 1: National Cancer Statistics

Link:https://academic.oup.com/jnci/article/113/12/1648/6312532?login=false

Citation: JNCI: Journal of the National Cancer Institute, Volume 113, Issue 12, December 2021, Pages 1648–1669, https://doi.org/10.1093/jnci/djab131

Graphic:

Excerpt:

Overall cancer incidence rates (per 100 000 population) for all ages during 2013-2017 were 487.4 among males and 422.4 among females. During this period, incidence rates remained stable among males but slightly increased in females (AAPC = 0.2%, 95% confidence interval [CI] = 0.1% to 0.2%). Overall cancer death rates (per 100 000 population) during 2014-2018 were 185.5 among males and 133.5 among females. During this period, overall death rates decreased in both males (AAPC = −2.2%, 95% CI = −2.5% to −1.9%) and females (AAPC = −1.7%, 95% CI = −2.1% to −1.4%); death rates decreased for 11 of the 19 most common cancers among males and for 14 of the 20 most common cancers among females, but increased for 5 cancers in each sex. During 2014-2018, the declines in death rates accelerated for lung cancer and melanoma, slowed down for colorectal and female breast cancers, and leveled off for prostate cancer. Among children younger than age 15 years and adolescents and young adults aged 15-39 years, cancer death rates continued to decrease in contrast to the increasing incidence rates. Two-year relative survival for distant-stage skin melanoma was stable for those diagnosed during 2001-2009 but increased by 3.1% (95% CI = 2.8% to 3.5%) per year for those diagnosed during 2009-2014, with comparable trends among males and females.

Conclusions

Cancer death rates in the United States continue to decline overall and for many cancer types, with the decline accelerated for lung cancer and melanoma. For several other major cancers, however, death rates continue to increase or previous declines in rates have slowed or ceased. Moreover, overall incidence rates continue to increase among females, children, and adolescents and young adults. These findings inform efforts related to prevention, early detection, and treatment and for broad and equitable implementation of effective interventions, especially among under resourced populations.

Author(s): Farhad Islami, MD, PhD, Elizabeth M Ward, PhD, Hyuna Sung, PhD, Kathleen A Cronin, PhD, Florence K L Tangka, PhD, Recinda L Sherman, PhD, Jingxuan Zhao, MPH, Robert N Anderson, PhD, S Jane Henley, MSPH, K Robin Yabroff, PhD, Ahmedin Jemal, DVM, PhD, Vicki B Benard, PhD

Publication Date: 8 July 2021

Publication Site: Journal of the National Cancer Institute