OVERVIEW - GENES THAT PREDISPOSE TO CANCER

Heredity and environment both operate in the origin of cancer. Dominantly heritable cancer is caused by 'cancer' genes that impart high relative risks but account for only a small part of the incidence of cancer; they are usually recessive in oncogenesis, mutation or loss of the second allele being necessary. Non-hereditary forms of cancer may involve the same genes. Other genes interact with environment in carcinogenesis; these may impart relatively small relative risks, but because their frequencies may be high, the attributable risks can be great, as probably is the case with lung cancer. The process of carcinogenesis is thought to involve 2 or more somatic genetic events in most cases. The genes whose germline mutations cause dominantly inherited cancer can also be mutated somatically to cause non-hereditary cancer. Other genes may influence the numbers of target cells, or the proliferation of once-hit stem cells, without being critical events on the path to cancer. However, such genes could greatly influence the incidence of a cancer. Other genes, such as that for Bloom's syndrome, may affect the rates at which first and second events occur. Finally, other genes may influence the occurrence of events critical for progression and metastasis, such as vascularization of a small tumor.