Cancer Genomics Epidemiology
The Michigan Department of Health and Human Services, 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).
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
Clinical Cancer Genetics Epidemiologist: Jillian Schrager, 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.
- A 2013 Michigan Behavioral Risk Factor Surveillance System (MiBRFSS) Surveillance Brief focusing on breast and ovarian cancer family history and genetic counseling among Michigan women can be found at the MiBRFSS website.
- Breast and Ovarian Cancer Genetic Counseling Among Michigan Women: Data from the 2011 Michigan Behavioral Risk Factor Survey (PDF)
- Cancer Genomics in Michigan: Surveillance Report 2012
- Utilization of Michigan Cancer Genetics Services, 2007-2011: Findings from the BRCA Clinical Genetic Counseling Database
- Innovative Utlization of a State Cancer Registry to Contact Young Breast Cancer Survivors and their High-Risk Female Relatives to Increase Breast Cancer Screening (PDF)
- Fear of Cancer Recurrence, Perceived Risk, Self-Efficacy and Barriers to Screening in Young Breast Cancer Survivors (PDF)
- Mutation Rates and Reasons for Declining BRCA Genetic Testing Among Women with Breast or Ovarian Cancer (PDF)
- Timing of BRCA Genetic Testing and Extent of Breast Cancer Surgery in Women with Deleterious Mutations (PDF)
- Family Notification and Cascade Screening After BRCA Genetic Testing (PDF)
- 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 to other sites related to cancer genomics epidemiology: