Genes impact endometrial cancer survival
Genetic factors may help explain why black women have a lower risk of developing endometrial cancer than white women, but a higher risk of dying from the disease.
Population-based cancer registries have shown that for endometrial cancer, "the difference in survival between blacks and whites is different than any other type of cancer," Dr. Andrew Berchuck told Reuters Health. Studies have shown that at the time of diagnosis, black women are more likely than white women to have advanced endometrial cancer -- cancer that has spread to other sites in the body.
According to study findings presented Sunday at the annual meeting of the Society of Gynecologic Oncologists in San Diego, California, white women are four times more likely than black women to have mutations in a tumor suppressor gene called PTEN.
A previous study from the team showed that black women had a higher frequency of p53 overexpression, another tumor suppressor gene, than white women.
"So the studies that we're doing are beginning to suggest that there is a reason for (the differences in survival), and that it has to do with the specific genetic alterations in the cancers of blacks and whites," Berchuck said. "Blacks tend to develop their cancers through pathways of genetic alterations that result in more aggressive, spreading cancers compared to white women."
Berchuck and colleagues at Duke University in Durham, and others at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina, screened 140 late-stage endometrial cancers for mutations in the PTEN gene. Of the 140 tumors, 78 were from white women and 62 from black women.
Overall, the researchers found PTEN mutations in 14% of endometrial tumors, which was associated with more favorable survival. However, mutations were found in 22% of tumors from white women and only 5% of tumors from black women.
Berchuck emphasized that these genetic changes are mutations acquired during life, not inherited. "We are not talking about something where these people are at risk for this cancer because they inherited these mutations. These women are born with normal genes but the mutations that cause cancer happen over the course of a lifetime."
What causes the differences in genetic alterations is not clear. "The genetic alterations are what cause the cancer, but something underlies the genetic alterations," he pointed out. Possibilities include environmental factors such as estrogen exposure, or differences in the ability of cancer cells to repair DNA damage.
Soc Gyn Onc Annual Meeting
Women's Cancer, 3/05
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