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Volume 336:1401-1408 May 15, 1997 Number 20 Next

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ABSTRACT

Background Carriers of germ-line mutations in BRCA1 and BRCA2 from families at high risk for cancer have been estimated to have an 85 percent risk of breast cancer. Since the combined frequency of BRCA1 and BRCA2 mutations exceeds 2 percent among Ashkenazi Jews, we were able to estimate the risk of cancer in a large group of Jewish men and women from the Washington, D.C., area.

Methods We collected blood samples from 5318 Jewish subjects who had filled out epidemiologic questionnaires. Carriers of the 185delAG and 5382insC mutations in BRCA1 and the 6174delT mutation in BRCA2 were identified with assays based on the polymerase chain reaction. We estimated the risks of breast and other cancers by comparing the cancer histories of relatives of carriers of the mutations and noncarriers.

Results One hundred twenty carriers of a BRCA1 or BRCA2 mutation were identified. By the age of 70, the estimated risk of breast cancer among carriers was 56 percent (95 percent confidence interval, 40 to 73 percent); of ovarian cancer, 16 percent (95 percent confidence interval, 6 to 28 percent); and of prostate cancer, 16 percent (95 percent confidence interval, 4 to 30 percent). There were no significant differences in the risk of breast cancer between carriers of BRCA1 mutations and carriers of BRCA2 mutations, and the incidence of colon cancer among the relatives of carriers was not elevated.

Conclusions Over 2 percent of Ashkenazi Jews carry mutations in BRCA1 or BRCA2 that confer increased risks of breast, ovarian, and prostate cancer. The risks of breast cancer may be overestimated, but they fall well below previous estimates based on subjects from high-risk families.

Source Information

From the Division of Cancer Epidemiology and Genetics, National Cancer Institute (J.P.S., P.H., S.W., M.A.T.), and the Laboratory of Gene Transfer, National Human Genome Research Institute (J.P.S., S.M.B., M.M.T., L.C.B.), National Institutes of Health, Bethesda, Md.; Westat, Inc., Rockville, Md. (M.B.); and IMS, Inc., Silver Spring, Md. (M.M.).

Address reprint requests to Dr. Struewing at the Genetic Epidemiology Branch, Bldg. EPN, Rm. 439, 6130 Executive Blvd., MSC 7372, Bethesda, MD 20892-7372.

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N Engl J Med 1997; 337:787-789, Sep 11, 1997. Correspondence

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