在未选择的犹太女性中筛查 BRCA1 和 BRCA2 的种系突变。
Screening for founder mutations in BRCA1 and BRCA2 in unselected Jewish women.
机构信息
Lawrence S Bloomberg, Faculty of Nursing and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
出版信息
J Clin Oncol. 2010 Jan 20;28(3):387-91. doi: 10.1200/JCO.2009.25.0712. Epub 2009 Dec 14.
PURPOSE
There are two mutations in BRCA1 and one mutation in BRCA2 that are present in up to 2.5% of Ashkenazi Jewish women. Current guidelines for testing stipulate that a personal or family history of cancer be present to be eligible for testing. To date, population screening in this population has not been suggested. However, this may be rational. Little is known about the appropriateness of testing guidelines for the Jewish population or the level of interest in testing.
METHODS
Eligible subjects were women who self-identified as Jewish, who were between the ages of 25 and 80 years, and who resided in Ontario. Subjects were recruited through an article in a national newspaper. Women were asked to complete a study questionnaire and a family history questionnaire and to provide a blood or saliva sample. The risk of carrying a BRCA mutation was estimated for each woman. Results A total of 2,080 women were enrolled onto the study. The overall mutation prevalence was 1.1% (0.5% for BRCA1 and 0.6% for BRCA2). Among the 22 mutation carriers, the mean estimate of carrying a BRCA mutation was 3.9%. Ten (45%) of the 22 women met the current Ontario Ministry of Health Guidelines criteria for testing.
CONCLUSION
There is considerable interest for genetic testing among Jewish women at low risk of carrying a mutation. However, many women with mutations are ineligible for genetic testing under current guidelines. Approximately 1% of Jewish women carry a BRCA mutation, and these women should be considered to be candidates for genetic testing.
目的
BRCA1 中有两个突变,BRCA2 中有一个突变,这些突变在多达 2.5%的阿什肯纳兹犹太女性中存在。目前的检测指南规定,个人或家族癌症史是有资格进行检测的。迄今为止,尚未建议对该人群进行人群筛查。然而,这可能是合理的。对于犹太人群体的检测指南的适宜性以及对检测的兴趣程度知之甚少。
方法
合格的受试者是自我认同为犹太人的女性,年龄在 25 至 80 岁之间,居住在安大略省。通过全国性报纸上的一篇文章招募受试者。要求女性填写一份研究问卷和一份家族史问卷,并提供血液或唾液样本。为每位女性估计携带 BRCA 突变的风险。
结果
共有 2080 名女性参加了这项研究。总体突变率为 1.1%(BRCA1 为 0.5%,BRCA2 为 0.6%)。在 22 名突变携带者中,携带 BRCA 突变的平均估计值为 3.9%。22 名女性中有 10 名(45%)符合安大略省卫生部目前的检测指南标准。
结论
携带突变风险低的犹太女性对基因检测有很大的兴趣。然而,根据目前的指南,许多携带突变的女性不符合基因检测的条件。大约 1%的犹太女性携带 BRCA 突变,这些女性应被视为基因检测的候选人。