The uncoupling of race and cancer genetics

✍ Scribed by Edison T. Liu

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 145 KB
• Volume: 83
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19981015)83:8+<1765::aid-cncr19>3.0.co;2-4

✦ Synopsis

The incidence of breast cancer is higher among white Americans than black Americans, but the mortality is significantly greater in blacks. One of the most common explanations for this discrepancy is that the biology or the genetics of African Americans and their tumors are different for whites. However, the argument that these differences are determined by genes is fundamentally flawed both on genetic and on social criteria. By using rough estimates of economic status and cancer stage, there is an approximate 12-30% residual difference in breast cancer mortality between the races that is not accounted for by measurable social factors.

As Asians move to the United States, there is a dramatic increase in breast and prostate cancer and a reduction in nasopharyngeal carcinomas, all approaching those of the host society. This is strong evidence that the effects of race on cancer incidence and mortality are attributable mainly to social, environmental, and cultural/behavioral factors and that genetics are secondary.

What is needed is a new mind set for dealing with race and cancer research.

Race should be viewed as a surrogate to identify social and cultural subgroups whose genetic pools and environmental exposures may differ from the general population. Therefore, we may use race 1) as a tool to identify high risk individuals, 2) for targeted intervention to prevent disease, and 3) to uncover the important economic, cultural, and behavioral contributions to cancer outcome. In conclusion, biology and genetics are the basis for understanding the cancer cell, but socioeconomic issues, such as access to health care, are vitally important in the outcome of cancer patients.