Lecture 63 Flashcards
A vast majority of cancer is due to what two factors?
1) Genetic predisposition
2) Environmental factors
What occurs in Familial adenomatous polyposis?
1) Predominantly due to Genetic predisposition (Penetrance is 100%)
2) Small benign tumor in colorectal epithelium (adenomas) grow
3) As tumors grow, cells become more disorganized
4) Eventually, a carcinoma forms
How do stomach and colon cancers compare for Japanese individuals living in Japan or the USA?
1) Colon cancer: very low (lifetime risk 0.5% in Japan vs. 5% in USA)
1st gen Japanese in Hawaii, colon cancer up several fold
2nd gen Japanese on U.S. mainland, colon cancer up to 5% (equal to US average)
2) Stomach cancer: common in Japan, rare in USA
What is the relative percentage of sporadic vs. familial cancers?
Sporadic: 90-95%
Familial: 5-10%
What is the age of onset for sporadic vs. familial cancers?
Sporadic: Later
Familial: Earlier
What is the inheritance pattern for sporadic vs. familial cancers?
Sporadic: None
Familial: Single gene dominant (predisposition)
What is the family history for sporadic vs. familial cancers?
Sporadic: Absent
Familial: Present, 1st degree relatives
What is the location of mutation in sporadic vs. familial cancers?
Sporadic: Somatic
Familial: Germline & somatic
What are the number of tumors for sporadic vs. familial cancers?
Sporadic: Single
Familial: Multiple
What are the locations of tumors for sporadic vs. familial cancers?
Sporadic: Unilateral
Familial: Multilateral
What is a relationship between incidence of cancer and age?
Incidence of cancer increases dramatically with age
Why does incidence of cancer increase with age?
1) Accumulation of mutations requires time
or
2) Perhaps defenses against cancer decline
What does an individual’s genetic background determine about cancer?
1) Susceptibility to carcinogens & enzymes needed to metabolize them
2) Susceptibility to DNA damage & efficiency of DNA repair enzymes
What are two types of mutagens that cause errors in DNA replication, repair or recombination and induce cancer?
1) Endogenous mutagens
2) Exogenous mutagens
What do endogenous mutagens result in and what are examples?
1) Spontaneous chemical modification of DNA
2) Result from:
a) Reaction oxygen species via oxidative metabolism
b) Deamination of C, A or G
c) Spontaneous depurination
What are examples of exogenous mutagens?
1) Diet
2) Smoking, sunlight, radon
3) Occupational and non-occupational chemical exposures
What must occur to a cell before cancer can arise?
1) A pre-cancerous cell requires multiple mutations and clonal expansions for cancer to arise
2) Generally 6 steps progress to cancer
What do clonal expansions of pre-cancerous cells with mutations result in?
Somatic mosaicism