Looking for genes that could boost a person's
general risk for cancer is not likely to reap
great rewards, new research concludes.
While vast sums of
money and resources are being invested in
the search for common, inherited genetic variants
that increase susceptibility to cancer, that
search faces big roadblocks.
The biggest one: Such genes probably don't
exist, scientists now say. And if they do,
they probably won't have much effect on the
incidence of cancer.
"Enthusiasm for this new field of research
should not precipitate unwarranted expectations,"
wrote experts Dr. Stuart Baker, from the U.S.
National Cancer Institute,
and Dr. Jaakko Kaprio, from the University
of Helsinki, Finland.
Their report appears in the May 13 issue
of the British Medical Journal.
They pointed to studies that suggest that
environmental, dietary or lifestyle changes
have a much larger effect on the incidence
of cancer than genetics do. Those studies
find changes in the incidence of cancer within
one generation or two generations, which is
just too quick to be related to the introduction
of new genes, Baker and Kaprio noted.
A pivotal study of cancer in twins also suggests
genes aren't the key culprits in cancer. Looking
at that data from identical and non-identical
twins, that study found that genetic susceptibility
had only a small-to-moderate effect on the
incidence of cancer.
Baker and Kaprio believe that studies that
have shown a strong association between
specific genes and a higher risk for cancers
may be biased.
"The search for common cancer susceptibility
genes faces important methodological and practical
challenges for cancer prevention, given the
small chance that such genetic variants exist
and the difficulty and expense of proving
substantial clinical benefit if they do exist,"
Baker and Kaprio wrote.
The researchers noted that certain genes
may enhance risks for very specific types
of cancer -- for example, the BRCA1 and BRCA2
genes that doctors know are strongly linked
to breast cancer. But genes that encourage
cancer generally are less likely, they said.
One expert agreed that genetics can only
go so far in determining anyone's risk for
cancer.
"The age of the human genome is here,"
said Dr. Michael Thun, vice president of epidemiology
and surveillance research at the
American Cancer Society. "The
understanding of genes will transform the
way we think about many diseases and is already
transforming the way we understand cancers."
But the idea that that your genetic makeup
is going to be the main factor that determines
your susceptibility to cancer has been oversold,
Thun added. "The things we know that
are bad for you are bad for you in so many
different ways that they won't become OK just
because you're less susceptible to one or
another disease," he said.
Genetics isn't going to transform efforts
to prevent cancer, Thun added. "The most
successful efforts to prevent cancer are going
to come from public policies that make it
easier to maintain a healthy body weight and
make it easier to get kids not to smoke,"
he said.
Most of the genetic changes that cause cancer
happen during your lifetime, not at birth,
Thun said. Still, "research on what the
genetic changes are that give rise to a cancer
is already profoundly important," he
said.