Cancer Genomics Epidemiology

The Michigan Department of Community Health, in collaboration with the Centers for Disease Control and Prevention, has created a multi-faceted, comprehensive cancer genomics program that encompasses public health surveillance, health education of providers, and policy interventions with health insurance plans.

The ultimate impact of these activities would be a reduction in early cancer deaths (before age 50) in Michigan residents as a result of appropriate translation of cancer genetic tests into clinical and public health practice, statewide surveillance and implementation of systems of care for inherited breast and ovarian cancer, and the use of best practice recommendation for family history, cancer genetic counseling and testing (BRCA1/2).

Epidemiology Summary 

Cancer is the second leading cause of death in Michigan and the United States. Cancers diagnosed before age 50 represent a meaningful portion of the state's cancer burden and cancers with early onset are more likely to represent hereditary forms of cancer.

BRCA1 and 2 mutations are dominant germline mutations that are associated with breast cancer diagnosed at an early age and ovarian cancer at any age. BRCA1/2 is responsible for 5-10% of all breast cancers and about 20% of breast cancer diagnosed in women under age 45. It is also responsible for 6% of ovarian cancers. Mutations in BRCA 1 and 2 confer an estimated 35-84% chance of a woman developing breast cancer by age 70 (compared to 10-12% in the general population) and a 10-50% chance of developing ovarian cancer.

Lynch syndrome is the most common form of a genetically determined colon cancer predisposition. It accounts for 3% of colorectal cancer diagnoses. The risk of developing colorectal cancer by age 70 in mutation carriers is estimated to be between 24 and 75% (compared to 4-5% in the general population), while the risk of endometrial cancer is between 27-70% (compared to 2-3% in the general population).

Cancer Genomics Epidemiology Staff

Cancer Genomics Epidemiologist: Beth Anderson, MPH 
Clinical Cancer Genetics Epidemiologist: Sarah Mange, MPH 

What We Do 

Our goal is to develop and implement a model for surveillance of inherited cancer and use of relevant genetic tests. Through the use of multiple data sets, including the Michigan Cancer Surveillance Program's registry data and clinical genetics data, we are monitoring the prevalence of disease, the use of clinical genetic services and the quality of care that is provided.

Surveillance Reports

• Cancer Genomics in Michigan: Surveillance Report 2012

1. BRCA 1/2 Surveillance in Michigan, 2008-2012 (PDF) 
2. Gene Expression Profiling (GEP) for Breast Cancer Recurrence Risk Prediction, Surveillance in Michigan, 2008-2012 (PDF)

• Utilization of Michigan Cancer Genetics Services, 2007-2011: Findings from the BRCA Clinical Genetic Counseling Database

1. Introduction (PDF)
2. Patient Demographics (PDF)
3. Referring Provider (PDF)
4. Age and Personal History (PDF)
5. Number of BRCA Tests Over Time (PDF)
6. Patient Services Over Time (PDF)
7. Test Results by Personal and Family History (PDF)
8. Characteristics of Patients Tested (PDF)

Presentations

• Examining Statewide Patterns in Collection of Family History Variables for the Michigan Cancer Surveillance Program (PDF)
  
  
• Growth of BRCA1/2 Genetic Testing in Michigan, 2008-2011 (PDF)
  
  
• Utilization of Cancer Genetic Services by Young Female Breast Cancer Survivors (PDF)
  
  
• Reasons for Declining BRCA Testing After Genetic Counseling (PDF)
  
  
• Using State Cancer Registries to Evaluate Potentially Hereditary Cancers (PDF) 

More publications and presentations related to cancer genomics in Michigan can be found at the Michigan Public Health Genomics Program website.

Links

Links to other sites related to cancer genomics epidemiology:

• Cancer Genomics Best Practices Project
• Michigan's Genetics Resource Center 

Click here to go back to the Chronic Disease Epidemiology Unit Webpage 

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