Care of men with cancer-predisposing BRCA variants
Care of men with cancer-predisposing BRCA variants
Men and women are equally likely to inherit or pass on a cancer-predisposing BRCA variant—family history of cancers needs to encompass both sides of the family
Men with cancer-predisposing BRCA variants have an increased risk of developing breast cancer and are advised to be breast aware
Men with cancer-predisposing BRCA2 variants have an increased risk of developing aggressive prostate cancer (men with cancer-predisposing BRCA1 variants may also have an increased risk); it is not yet known whether prostate specific antigen screening reduces mortality in men with cancer-predisposing BRCA variants
The European Association of Urology recommends that PSA screening is offered to men with cancer-predisposing BRCA2 variants from 40 years of age after discussion of the risks and benefits
Around one in 260 men (~0.4%) inherits a cancer-predisposing BRCA variant that increases their risk of developing prostate, pancreatic, and breast cancer and may affect the health of their family.12 Most of these men are currently unaware that they have a cancer-predisposing BRCA variant, but as genetic testing becomes more common, more men will need medical advice about what having such a variant means for them and their families.
Men are just as likely as women to have a cancer-predisposing BRCA variant, but many people perceive these variants as only being relevant to women. Paradoxically, this could lead to women at very high risk of breast and ovarian cancer missing out on screening and risk-lowering treatment despite a concerning paternal family history. Clinicians might also be less attuned to paternal family history of cancer in assessing women’s breast cancer risk.3 This practice pointer covers what cancer-predisposing BRCA variants are, who might be tested; and what health issues men and their clinicians need to know about. We refer to men but this article may also apply to some transgender and non-binary people: their risk profiles and recommended care should be appropriately individualised.
Horton, Rachel
f79e8b73-2edc-47aa-b29a-1801ad10fe6b
Lucassen, Anneke
2eb85efc-c6e8-4c3f-b963-0290f6c038a5
Pharoah, Paul
64b86198-95c7-4b5d-81b1-169f57054cbd
Hayward, Judith
407db60a-0487-4b1a-8d55-f44836d14a26
14 October 2021
Horton, Rachel
f79e8b73-2edc-47aa-b29a-1801ad10fe6b
Lucassen, Anneke
2eb85efc-c6e8-4c3f-b963-0290f6c038a5
Pharoah, Paul
64b86198-95c7-4b5d-81b1-169f57054cbd
Hayward, Judith
407db60a-0487-4b1a-8d55-f44836d14a26
Horton, Rachel, Lucassen, Anneke, Pharoah, Paul and Hayward, Judith
(2021)
Care of men with cancer-predisposing BRCA variants.
The BMJ, 375 (2376), [n2376].
(doi:10.1136/bmj.n2376).
Abstract
Men and women are equally likely to inherit or pass on a cancer-predisposing BRCA variant—family history of cancers needs to encompass both sides of the family
Men with cancer-predisposing BRCA variants have an increased risk of developing breast cancer and are advised to be breast aware
Men with cancer-predisposing BRCA2 variants have an increased risk of developing aggressive prostate cancer (men with cancer-predisposing BRCA1 variants may also have an increased risk); it is not yet known whether prostate specific antigen screening reduces mortality in men with cancer-predisposing BRCA variants
The European Association of Urology recommends that PSA screening is offered to men with cancer-predisposing BRCA2 variants from 40 years of age after discussion of the risks and benefits
Around one in 260 men (~0.4%) inherits a cancer-predisposing BRCA variant that increases their risk of developing prostate, pancreatic, and breast cancer and may affect the health of their family.12 Most of these men are currently unaware that they have a cancer-predisposing BRCA variant, but as genetic testing becomes more common, more men will need medical advice about what having such a variant means for them and their families.
Men are just as likely as women to have a cancer-predisposing BRCA variant, but many people perceive these variants as only being relevant to women. Paradoxically, this could lead to women at very high risk of breast and ovarian cancer missing out on screening and risk-lowering treatment despite a concerning paternal family history. Clinicians might also be less attuned to paternal family history of cancer in assessing women’s breast cancer risk.3 This practice pointer covers what cancer-predisposing BRCA variants are, who might be tested; and what health issues men and their clinicians need to know about. We refer to men but this article may also apply to some transgender and non-binary people: their risk profiles and recommended care should be appropriately individualised.
Text
Author accepted manuscript BRCA
- Accepted Manuscript
More information
e-pub ahead of print date: 14 October 2021
Published date: 14 October 2021
Additional Information:
Funding Information:
Funding: Rachel Horton’s work is funded by a Wellcome Trust Research Award for Health Professionals in Humanities and Social Science 218092/Z/19/Z. Anneke Lucassen’s work is supported by funding from a Wellcome Trust collaborative award 208053/Z/17/Z.
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Local EPrints ID: 452039
URI: http://eprints.soton.ac.uk/id/eprint/452039
ISSN: 0959-8138
PURE UUID: 8999d70b-8494-4b8e-8f88-ba8aec1a734c
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Date deposited: 09 Nov 2021 17:32
Last modified: 17 Mar 2024 02:54
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Author:
Paul Pharoah
Author:
Judith Hayward
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