Inherited genes and specific cancers
This page has information about inherited gene faults that can increase your risk of developing cancer. There is information about
Researchers are finding new genes all the time that are linked to particular types of cancer. But this is a complicated area of research and it will be some time before we fully understand how inherited gene faults cause particular cancers. There are only a few genes that doctors can test for at the moment.
There is more information about how genes can cause cancer in this section.
Below there is information about cancers that we know can be linked to inherited faulty genes and that you can have a test for. We haven’t included genes that are known about but that we cannot test for. You can find out more in the risks and causes section of the cancer type you are interested in.
If you think there may be a cancer gene fault in your family, the first thing to do is to see your GP. Your GP will talk to you about your family history. If they think you may have a strong family history of cancer they will refer you to a specialist clinic. There, you will see a genetics counsellor who can begin to look in to the number of cancer cases in your family.
Bowel cancer is the 3rd most common type of cancer in the UK. 1 in 15 men and 1 in 19 women will develop bowel cancer during their lifetime. The genes that increase your risk of developing bowel cancer and can be tested for are
- FAP or familial adenomatous polyposis (the APC gene)
- MAP or MYH associated polyposis (the MYH gene)
- HNPCC or Lynch syndrome (the MLH1, MSH2, MSH6 genes)
- Peutz Jeghers syndrome (the STK11 gene)
If you are known to have a gene that increases bowel cancer risk, your specialist may suggest that you have regular screening.
Familial adenomatous polyposis (FAP) is caused by a fault in the APC gene. It is a rare disease that causes 1 in 100 bowel cancers (1%). A faulty APC gene can cause hundreds of non cancerous growths called polyps to develop in the bowel at a young age. Over a long time, these polyps can develop into a cancer. Your risk of cancer is greater because you have many more of these polyps than someone without this gene fault.
Rarely, people can develop FAP without any family history. This means that the gene fault has happened during your lifetime. You haven’t inherited it. There is more information about FAP in our bowel cancer section.
MYH associated polyposis (MAP) is caused by an MYH gene fault. It is much rarer than FAP (familial adenomatous polyposis). To have MAP you need two faulty MYH genes, one from each parent. To develop FAP, you only need one faulty copy of the gene.
Hereditary non polyposis colon cancer (HNPCC) is also called Lynch syndrome. It is caused by faults in MLH1, MSH2 and MSH6 genes. These repair DNA. HNPCC is rare and accounts for between 2 and 5 out of every 100 bowel cancers (2 to 5%). Between 7 and 9 out of 10 people with HNPCC (between 70 and 90%) develop bowel cancer.
If you have HNPCC you are at higher risk of developing other cancers including womb, ovary, stomach, small bowel, liver, gallbladder, and brain tumours.
Peutz-Jeghers syndrome is linked to a gene fault called STK11. Peutz Jeghers increases the risk of bowel cancer as well as other types of cancer. It is very rare so it is difficult to find any reliable figures.
Breast cancer is a common cancer with 1 in 8 women developing it during their lifetime in the UK. Fewer than 3 out of every 100 breast cancers (3%) are caused by an inherited faulty gene. The genes that increase risk of breast cancer and can be tested for are
If you are known to have a gene that increases breast cancer risk, your specialist may suggest that you have regular screening.
Between 45 and 90 women out of 100 (45 to 90%) with a faulty BRCA1 or BRCA2 gene develop breast cancer during their lifetime.
Faulty BRCA1 and 2 genes are rare. But they can also increase the risk of other cancers such as ovarian cancer, pancreatic cancer and prostate cancer.
Faults in TP53 and PTEN mutations are rarer than BRCA gene mutations.
The TP53 gene normally controls when a cell divides. It is a type of tumour suppressor gene. It causes breast cancer as part of a rare cancer syndrome called Li Fraumeni syndrome. It causes fewer than 1 in 100 (1%) of all breast cancers diagnosed.
PTEN is the gene fault in a rare condition called Cowden syndrome. It increases your risk of breast cancer.
CHEK2 is another type of tumour suppressor gene. It helps to stop cells from growing and dividing too rapidly or in an uncontrolled way. Faults in the CHEK2 gene are rare.
A faulty CHEK 2 gene causes fewer than 2 out of every 100 breast cancers. If you have this gene you also have a higher risk of getting a second breast cancer.
Kidney cancer is the 8th most common cancer in the UK. 1 in 61 men and 1 in 100 women develop it during their lifetime in the UK.
We know that if you have a family history of kidney cancer your risk is increased. And if your brother and sister has had kidney cancer you have a 4 times greater risk of kidney cancer than if they didn’t have kidney cancer. This may be because of shared way of life or more rarely because of inherited faulty genes. Researchers are looking into which genes may increase the risk of developing kidney cancer.
We know that there are a number of inherited conditions that increase your risk of developing it. They are very rare and together only account for about 2% of kidney cancers. They are
- Von Hippel Landau (VHL) syndrome
- Tuberous sclerosis (TS)
- Birt-Hogg-Dube syndrome
- Hereditary papillary renal cell cancer
- Hereditary leiomyomatosis and renal carcinoma
Von Hippel Landau (VHL) syndrome is caused by faults in the VHL gene. It is a rare inherited condition affecting about 1 in 36,000 people. 4 out of 10 people (40%) with VHL syndrome develop a type of kidney cancer called clear cell renal cell cancer (CCRCC). Kidney cysts are common in VHL syndrome. These cysts do not usually affect kidney function, but CCRCC can develop in a cyst. People who carry the gene fault also have an increased risk of developing other rare cancers in the brain, spine, pancreas, eyes and inner ear.
Tuberous sclerosis (TS) is caused by faults in the TSC1 and TSC2 genes. About 1 in 10,000 people have it. About 1 in 3 cases are inherited. In the other 2 out of 3 cases it occurs as a new event in that person. It can cause skin, brain and heart problems, as well as kidney disease. People with TS have an increased risk of kidney cysts and papillary kidney cancer.
Birt-Hogg-Dube syndrome (BHDS) is caused by faults in the FLCN gene (also known as BHD). Individuals with BHDS develop multiple benign skin tumours (fibrofolliculomas ) on the face, neck and upper body. People with BHDS are at increased risk of kidney cancer. It is a very rare condition and the number of people and families with BHDS is not known.
Isolated hereditary papillary renal cell cancer (HPRCC) is caused by faults in the MET gene. It is a very rare condition and the number of people with HPRCC is unknown. Doctors may suspect it in families when lots of relatives have papillary renal cell carcinoma.
Hereditary leiomyomatosis and renal carcinoma (HLRCC) is caused by faults in the FH gene. People with HLRCC have benign skin tumours (cutaneous leiomyomata), fibroids in the womb (uterine leiomyomata) and may have kidney cancer. Papillary renal cancer is the most common kidney cancer in HLRCC, but other types, for example tubulo-papillary renal cell cancer and collecting-duct renal cell cancer, can develop. It is a very rare condition and the number of people with HLRCC is not known.
Melanoma is a type of skin cancer. In the UK, almost 12,000 people are diagnosed with melanoma each year. About 1 in 10 people (10%) who have melanoma have a strong family history of the disease. People with a family history are at increased risk.
Researchers have found that the family cancer syndrome - familial atypical multiple mole melanoma (FAMMM) increases your risk of developing melanoma. One of the causes of FAMMM is a faulty CDKN2A gene. Recent research suggests that just over 1 in 4 people (25%) with a faulty CDKN2A gene will develop melanoma by the age of 80 years. The research suggests that your risk varies depending on where in the world you live. For example people with a faulty CDKN2A gene who live in Australia have a higher risk than those in the UK with a faulty gene. Researchers think that other factors including other gene changes or environmental factors may alter the amount your risk is increased by having a faulty CDKN2A.
People who have FAMMM have either more than 50 moles or at least one person in their family has been diagnosed with a melanoma. People with FAMMM are also at a higher risk of developing pancreatic cancer. There is a genetic test for a faulty CDKN2A.
On average, 1 out of every 54 women in the UK will develop ovarian cancer during their lifetime. The genes that are known to increase risk of ovarian cancer, and that you can have a test for are
If you have one of these faulty genes, what happens next will depend on which one you have. Your specialist may suggest screening. Or, depending on your age and whether you’ve had all the children you want to have, they may advise surgery to remove your womb and ovaries. There is information about screening for high risk groups in the ovarian cancer section.
Of all women with a faulty BRCA1 gene, between 4 and 6 out of 10 (40 to 60%) will develop ovarian cancer at some point in their lives. A BRCA 1 gene fault also increases breast cancer risk.
Between 1 and 3 out of 10 women with a faulty BRCA2 gene (10 to 30%) will develop ovarian cancer at some point. A BRCA 2 gene fault also increases breast cancer risk.
HNPCC stands for hereditary non polyposis colorectal cancer. This is also called Lynch syndrome. The genes that cause it are MLH1, MSH2 and MSH6. HNPCC is more commonly linked to bowel cancer but can also slightly increase the risk of ovarian cancer. Between 10 and 15 out of 100 women with HNPCC (10 - 15%) will develop ovarian cancer. Researchers think that around 2 out of every 100 ovarian cancers diagnosed (2%) are linked to HNPCC.
In the UK, around 5 out of every 200 cancers diagnosed (2.6%) are pancreatic cancer. Around 1 in 77 men and 1 in 79 women will develop it at sometime in their lifetime. Researchers estimate that a cancer gene fault causes about 1 in 10 pancreatic cancers (10%). Although they can see that it can run in families, scientists haven’t found a single gene fault that causes this, so there isn’t a test at the moment. Researchers are looking into the best way of monitoring people with a strong family history.
If your doctor thinks you have a strong family history of pancreatic cancer, they may suggest regular monitoring for the disease. You can find more information about screening for pancreatic cancer in the pancreas cancer section.
Cancer of the pancreas can also develop as part of one of the family cancer syndromes. The ones that tests are available for include
- The faulty breast cancer gene - BRCA2 gene
- Familial melanoma (Familial atypical multiple mole melanoma syndrome (FAMMM) – CDKN2A gene
- Peutz-Jeghers syndrome – STK11 gene
- Hereditary non polyposis colorectal cancer (HNPCC)
- Familial adenomatous polyposis – APC gene
- Multiple endocrine neoplasia type 1 – MEN1 gene
These syndromes are covered on this page in the other cancer type sections.
Prostate cancer is now the most common cancer in men. The lifetime risk for a man in the UK is 1 in 9. Remember it is most common over the age of 70 so your risk at 50 is much lower than this. Scientists have found a number of genes that increase risk of prostate cancer. At the moment there are only tests available for BRCA1 and BRCA2 genes. These genes are more commonly linked to breast and ovarian cancer.
If you have a faulty BRCA2 gene, your risk of getting prostate cancer before the age of 65 is 7 times higher than a man without a faulty gene. After the age of 65 you have a 4 ½ times greater risk of prostate cancer than a man without a gene fault.
The research into the BRCA1 gene is less clear and some studies have found that it doesn’t significantly increase the risk of prostate cancer. We need more research to find out.
There is a trial for men with a high risk of developing prostate cancer because they have faulty BRCA1 or BRCA2 genes. The trial is looking at whether the PSA test combined with a biopsy is a good way of picking up prostate cancer early in these men. It is called the IMPACT study. You can find out more about this trial on our clinical trials database.
Retinoblastoma is a rare cancer that develops in young children. Between 40 and 50 children get retinoblastoma every year in the UK. It affects the part of the eye which detects light and colour - the retina. About 4 out of 10 children who develop retinoblastoma (40%) have inherited a faulty gene called RB1. The cause of the other 6 out of 10 (60%) is unknown. There is a test available for this gene.
About 2,100 people are diagnosed with thyroid cancer each year in the UK. There are a number of different types of thyroid cancer. Papillary thyroid cancer is the most common type. Between 1 in 10 and 1 in 20 thyroid cancers (10 to 20%) are medullary thyroid cancers. About 1 out of 4 medullary thyroid cancers (25%) are caused by an inherited faulty gene. More rarely papillary thyroid cancers are caused by an inherited faulty gene.
Faulty genes may cause medullary thyroid cancer as part of a rare syndrome called multiple endocrine neoplasia or MEN for short. The types of MEN that cause thyroid cancer are MEN2a and MEN2b.
People with MEN2a are also at higher risk of developing a rare type of cancer of the adrenal gland and an overactive parathyroid gland. People with MEN2b are at higher risk of getting adrenal cancer and small growths on their tongue and lips.
If 4 or more members of a family have a medullary thyroid cancer but don’t have any other cancer or one of the other conditions which may be linked to MEN, doctors usually diagnose it as familial medullary thyroid cancer (FMTC for short).
There is also information about screening for people who have a high risk of thyroid cancer.
About 1 in 46 women in the general population will develop womb cancer. Between 4 and 6 out of 10 women (40 – 60%) with a rare condition called Lynch syndrome (also called HNPCC) will get womb cancer. Lynch syndrome also increases the risk of developing a number of other cancers including bowel and ovarian cancer.
Another gene that increases the risk of womb cancer is a faulty PTEN gene. This gene is faulty as part of a rare condition called Cowden syndrome.
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