Broader genetic testing offers new hope in quelling cancer
An oncologist believes more genetic testing could be among answers to improving the health of Bermudians.
Kevin Hughes, medical director of the Bermuda Cancer Genetics and Risk Assessment Clinic, said the island’s small size makes it easier to flag up people with certain genes presenting a health risk.
He explained: “Let’s say there are a couple thousand mutation carriers in Bermuda — a large number of them are coming from the same family, so it might be easier to identify a patient with a mutation, get their family members with that mutation and then really have a major impact on the population health if we can get more of this testing done.”
The Bermuda Cancer Genetics and Risk Assessment Clinic has identified 17 genes rendering their hosts susceptible to cancer, from 513 participants since its work kicked off 20 years ago.
Dr Hughes said this data may differ from the rest of the world — but highlighted how the clinic has expanded from testing only two genes to now being able to identify 91 different types.
Until 2013, the programme tested for the BRCA1 and BRCA2 genes, which contribute to ovarian and early-onset breast cancer, as those were the only tests commercially available up to that point.
Dr Hughes said: “DNA testing has gotten cheaper and cheaper over time because it’s less expensive. You can do 90 genes for the price of doing two genes before.”
He added: “With these newer genes that are coming along, we’re starting to understand them and how to manage them better.
“As we learn more about them, we’re more comfortable testing for them and trying to identify those mutations and then do something about it once we find them.”
Dr Hughes said test subjects with mutated genes ranged from 24 to 82 years old, with an average age of 50. Sixty-eight per cent were White and 86 per cent were women.
“I think if more people were tested, the numbers would more likely approximate the population of Bermuda,” he said.
“As our initial focus was breast cancer, and that is what gets the most attention in the public sphere, not surprised we have more females tested.”
Dr Hughes said BRCA1 and BRCA2 are more common, while other genes are found in one in 40,000 or 50,000 people.
He said: “The risk of having these genes could go up significantly when you have an island population. It can also go down where there are no carriers of that type on the island.
“Overall, I think the mix [in Bermuda] would probably be different than elsewhere in the world just given the small population.”
Dr Hughes meets patients with mutated genes annually through a hereditary clinic at the Bermuda Cancer and Health Centre.
He said: “The hereditary cancer clinic makes sure everybody complies with what’s supposed to be done, but also keeps them up to date on what’s changing.”
Dr Hughes voiced hope more men would avail themselves of testing, but encouraged anyone with a strong history of cancer in their families to book a test, which is normally done on the island three or four times a year, through the Bermuda Cancer and Health Centre.
He said: “We find that awareness of genetic risk tends to be more among women because most of the papers you read are about breast cancer and ovarian cancer, but men are at risk for colon, prostate and pancreatic cancer as well.
“We’d love to get more of those men in for testing and we try to get them in as parts of families when we find mutations, but we need to do a lot more testing and a lot more awareness about the male population as well.”
Test participants provide saliva samples and typically receive results within four to six weeks, or as soon as ten days in urgent cases.
• Visithereditarycancer.ai to learn more about Dr Hughes’ work and cancer genes and see Related Media to look at the genetic results for Bermuda
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