Is Cancer Risk Higher for the Ashkenazi Jewish Population?

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Is the Ashkenazi Jewish population at a higher risk for certain types of cancers? Dr. Angela Bradbury from Perelman School of Medicine at the University of Pennsylvania shares her perspective on this controversial topic—touching on the ongoing researching in this area and necessity of screening.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Dr. Bradbury:

This is a controversial area. There has been advocacy for population screening for BRCA1 and 2 mutations, in the Ashkenazi Jewish population, because the prevalence of mutations is so high. What I would say is that any woman that has a BRCA-related cancer in their history, breast cancer survivor, new ovarian cancer diagnosis, or ovarian cancer survivor who is Ashkenazi Jewish heritage, is a great candidate for genetic testing and is very, very likely to be covered by insurance. 

That is the place where I would urge some individuals if it is a later onset and looks more like a sporadic cancer, they may not test positive, but the incidence is high enough in the Ashkenazi population to definitely go forward.

In that there is not much controversy for the cancer patient who has a BRCA-type cancer, there is not cancer about them being tested. The controversy is over screening the entire Ashkenazi population.I think there are some merits to that with genetic testing because of the prevalence of the mutation, but there are also some limitations. I will touch on touch a couple of them, and this is not a resolved controversy.

One of the issues is that we don’t have a lot of data on what the cancer risks are for people who don’t have the cancer in their family. So all of the risk estimates for BRCA carriers, about lifetime risk of breast cancer, ovarian cancer, and age-related risks, come from large studies where there are multiple cases of cancer. We have less data of what those risks are if you come to the table with no cancer history. You may carry the same risks, or maybe you don’t, and that is something that we don’t know.

To me, that is not a reason to not necessarily offer population screening to the Ashkenazi population, but it is something that you would want people to understand. Because, women would be facing things like prophylactic mastectomy, prophylactic oophorectomy, and that maybe more than they need to do, because of the scientific gap. So there is a lot of controversy, I think that for the person that is really advocacy at your synagogue for women to get testing for the families with that family history, yes. 

For others with absolutely no family history, that looks like BRCA, I think it is a bit of a cautionary tale. There are ongoing studies trying to understand this better. There may be a day and a time where I would say, yes, that is something that you should do. It is a good place to start thinking about that, as opposed to every woman over the age of 35. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on March 16, 2017
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