Life Lessons on Cancer Risk for Children Whose Parent Has Genetic Mutation

Parents found to be carriers of a mutated form of the tumor suppressor genes known as BRCA1 and BRCA2 do not always share these test results with their children, but they may choose to discuss related information important to their own health with them. That is the result of a study conducted by a team of investigators from The Cancer Institute of New Jersey (CINJ) and Fox Chase Cancer Center, whose findings suggest that those parents are using the discovery of their mutation status as an opportunity for a “teachable moment” in educating their offspring about cancer risk reduction. The research is being presented in abstract form next month in Chicago during the 2010 Annual Meeting of the American Society of Clinical Oncology (ASCO). CINJ is a Center of Excellence of UMDNJ-Robert Wood Johnson Medical School.

Studies have shown that men and women who harbor a mutation in the BRCA tumor suppressor genes are at greater risk for developing certain types of cancers - particularly ovarian cancer in women and breast cancer in both men and women.

Surveys were completed by 108 parents (belonging to 215 parent-offspring pairs) asking them if they communicated information to their children (younger than 25) about testing positive for a BRCA gene mutation.

The study found that 59 percent of offspring learned of their parents’ BRCA mutation status. Of that number, 97 percent of children learned of their parents’ cancer risk and 82 percent of offspring learned of their own chance of developing cancer from inheriting the mutated gene. Within this group, 76 percent of children learned of what their parents can do to reduce their risk of cancer, while 63 percent of the offspring learned of strategies they could use to reduce their own cancer risk.

Among the group of children whose parents did not tell them about their BRCA mutation status (41 percent), 31 percent learned of a parent’s overall cancer risk, while nine percent learned of their own cancer risk should they inherit a mutated BRCA gene from their parent. Thirty-six percent of offspring from this group learned of what their parents can do to reduce their cancer risk, while 35 percent learned about risk-reduction strategies for themselves.

Further analysis identified certain predictors as to what information would be disclosed by the parent to the offspring. For instance, parents who were female, college educated and had older offspring were more likely to share information with their child about a BRCA mutation. Risk reduction factors for both parent and child were more likely discussed if both were female, the child was older and the parent had been diagnosed with cancer.

Linda Patrick-Miller, PhD, CINJ member and assistant professor of psychiatry at UMDNJ-Robert Wood Johnson Medical School, is the study’s lead author. “The importance of identifying ‘teachable moments,’ is that with intervention, we might be able to enable more parents taking advantage of that opportunity to help their children reduce their own cancer risk or help them do it in a way that will be more effective. This is especially important in families with hereditary cancer syndromes, which place them at increased risk of early onset cancers,” she noted. “Identifying the profiles of the parent and offspring who already are using this ‘teachable moment’ is one of the first steps in understanding who should be targeted for an intervention and how that intervention should be designed.”