Cancer Risk Assessment and Screening; A Challenge for Clinical Pathology Service?

Siti Boedina Kresno

Abstract


There is evidence demonstrating that cancer etiology is multi-factorial and modification of risk factors has achieved
cancer prevention. There is therefore a need to advance the understanding of cancer etiology through interaction effects
between risk factors when estimating the contribution of an individual to the cancer burden in a population. It has been
known that cancer may arise from genetic susceptibility to the disease as an intrinsic factor; however, non-intrinsic factors
drive most cancer risk as well and highlight the need for cancer prevention. Are our clinical pathologists aware of these
facts?. Are they ready to understand and to provide an excellent test with good expertise?. Hereditary cancer testing is
typically performed using gene panels, which may be either cancer-specific or pan-cancer to assess risk for a defined or
broader range of cancers, respectively. Given the clinical implications of hereditary cancer testing, diagnostic laboratories
must develop high-quality panel tests, which serve a broad, genetically diverse patient population. The result will determine
a patient's eligibility for targeted therapy, for instance, or lead a patient to prophylactic surgery, chemoprevention, and
surveillance. This review will introduce the definitions of intrinsic and non-intrinsic risk factors, which have been employed in
recent work and how evidence for their effects on the cancer burden in human subjects has been obtained. Genetic testing
of cancer susceptibility genes by use of liquid biopsies and New Generation Sequencing (NGS) is now widely applied in
clinical practice to predict the risk of developing cancer, help diagnosis, and treatment monitoring.


Keywords


Cancer risk factors, intrinsic, non-intrinsic, gene variants, multi-panel gene testing

Full Text:

PDF

References


Wu S, Zhu W, Thompson P, Hannun YA. Evaluating

intrinsic and non-intrinsic cancer risk factors. Nature

Communications, 2018; 9: 3490.

Podolski DI, Gladyshev VN. Intrinsic vs. extrinsic cancer

risk factors and aging. Trends Mol Med, 2016; 22(10):

-34.

Revelo AE, Martin A, Velasquez R, Kulandaisamy PC,

Bustamante J, et al. Liquid biopsy for lung cancers: An

update on recent developments. Ann Transl Med,

; 7(15): 349.

Hiraki S, Rinella ES, Schnabel F, Oratz R, Ostrer H.

Cancer risk assessment using genetic panel testing:

Consideration for clinical application. J Genet Counsel,

; 23: 604-617.

Al-Bader SB, Alsulaiman R, Bugrein H, Ben Omran T,

Abbaszadeh F, et al. Cancer genetics program:

Follow-up on clinical genetics and genomic medicine

in Qatar. Molecular Genetics & Genomic Medicine,

; 6(6):865-872.

Pruthi S, Heisey RE, Bevers TB. Chemoprevention for

breast cancer. Ann Surg Oncol, 2015; 22(10): 3230-3235.

Turnbull C, Hodson S. Genetic predisposition to

cancer. Clin Med, 2005; 5(5): 491-98.

Bowles KR, Mancini-DiNardo D, Coffee B, Cox HC, Qian

Y, et al. Hereditary cancer testing challenges:

Assembling the analytical pieces to solve the patients

clinical puzzle. Future Oncol, 2019; 15(1): 65-79.

Horakova D, Bouchalova K, Cwiertka K. Risks and

protective factors for triple negative breast cancer

with a focus on micronutrients and infections. Biomed

Pap Med Fac Univ Palacky Olomouc Czech Repub,

; 162(2): 83-89.

Doerstling SS, O'Flanagan CH, Hursting SD. Obesity

and cancer metabolism: A perspective on interacting

tumor-intrinsic and extrinsic factors. Front Oncol,

; 7: 216.

Heymsfield SB, Wadden TA. Mechanisms,

pathophysiology and management of obesity. N Engl

J Med, 2017; 376(3): 254-66.

Vernieri C, Casola S, Folani M. Targeting cancer

m e t a b o l i s m : D i e t a r y a n d p h a r m a c o l o g i c

interventions. Cancer Discov, 2016; 6(12): 1315-33.

Zhu W, Wu S, Hannun YA. Contributions of the intrinsic

mutation process to cancer mutation and risk

burdens. E-Bio Medicine, 2017; 24: 5-6.

Wu S, Hannun Y. The importance of extrinsic factors in

the development of cancers. Mol & Cellular Oncol,

; 3(3): e1143079.

Elinav E. Inflammation-induced cancer: Crosstalks

between tumors, immune cells and microorganisms.

Nat Rev Cancer, 2013; 13: 759-71.

Mantovani A, Allavena P, Sica A. Cancer-related

inflammation. Nature, 2008: 454: 436-44.

Yu H, Pardoll D, Jove R. STAT's in cancer inflammation

and immunity: A leading role for STAT3. Nat Rev

Cancer, 2009; 9: 798-809.

Parker KH, Beury DW, Ostrand-Rosenberg S.

Myeloid-derived suppressor cells: Critical Cells driving

immune suppression in the tumor microenvironment.

Advance in Cancer Research, 2015; 128: 95-139.

de Malgahaes, JP. How aging process influence

cancer. Nat Rev Canc, 2013; 13: 357-65.

Donehover LA. MLH-1 silenced and non-silenced

subgroups of hypermutated colorectal carcinomas

have distinct mutational landscape. J Pathol, 2013;

: 99-110.

Guida F. Dynamics of smoking-induced genome-wide

methylation changes with time since smoking

cessation. Hum Mol Genet, 2015; 24: 2349-59.

Schiller JT, Lowy DR. Understanding and learning from

the success of prophylactic human papillomavirus

vaccines. Nat Rev Microbiol, 2012; 10: 681-92.

Fujimoto A, Furuta M, Totoki Y. Whole genome

mutational landscape and characterization of

noncoding and structural mutations in liver cancer.

Nat Genet, 2016; 48: 500-509.

McGlynn KA, London WT. The global epidemiology of

hepatocellular carcinoma present and future. Clin

Liver Dis, 2011; 15: 224-43.

Backert S, Blaser MJ. The role of CagA in the gastric

biology of Helicobacter pylori. Cancer Res, 2016; 76:

-31.

Graham DY, Dore MP. Helicobacter pylori therapy: A

paradigm shift. Expert Rev Anti Infect Therapy, 2016;

: 577-85.

Beggs AD, Hodgson SV, Genomics and breast cancer:

The different levels of inherited susceptibility. Eur J

Hum Gen, 2009; 17: 855-56.

Hodgson S. Mechanisms of inherited cancer

susceptibility. J Zhejiang Univ Sc B. 2008; 9(1): 1-4.

Kobayashi H, Ohno S, Sasaki Y, Matsuura M. Hereditary

breast and ovarian cancer susceptibility genes

(review). Oncol Rep, 2013; 30: 1019-29.

O'Mara TA, Glubb DM, Kho PF, Thomson DJ, Spurdle

AB. Genome-wide association studies of endometrial

cancer: Latest developments and future direction.

Cancer Epidemiol Biomarkers Prev, 2019; 28(7):

-1102.

Klonowska K, Ratatjska M, Wojciechowska M,

Kozlowska P. Genetic predisposition to breast and/or

ovarium cancer- focus on the candidate BARD-1 gene.

Journal of Biotechnology, Computational Biology and

Bionanotechnology, 2014; 95(3)C: 203-214 C.

Plon SE, Eccles DM, Easton D, Foulkes WD, Genuardi M,

et al. For the IARC unclassified genetic variants

working group. Sequence variant classification and

reporting: Recommendations for improving the

interpretation of cancer susceptibility genetic test.




DOI: http://dx.doi.org/10.24293/ijcpml.v27i1.1660

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.