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By Megan Cooley

Megan CooleyThe idea of cancer as bad luck has been grabbing everyone’s attention lately, since the article was released in early January. Cancer is really just “bad luck”? How can this be? Millions if not billions of dollars are pumped into cancer research every year. Endless time is spent by researchers in industry and academia working to identify genes that drive cancer. A paper published by the same group late last year stated that there were only three drivers genes required for progression of cancer. The authors suggest in their more recent publication that 65% of genes that cause cancer are purely random mutations.

If we think about this, these numbers are not really astonishing, and what they are implying is not either. When we break it down, we are really looking at random mutations versus familial mutations, which is not necessarily a novel concept. Genes such as BRCA1/2 have long been identified as inherited genetic mutations that pose increased risk of breast cancer and ovarian cancer, although to a lesser degree in women. Similarly, we know that certain lifestyle choices such as prolonged exposure to UVA/B rays from the sun or smoking cigarettes also cause increased risk of melanoma and lung cancer.

Perhaps the puzzling point to this article is that the reader might think that this study argues against diagnostic screening or early detection. If we believe that cancer arises from stem cell populations that have the ability to self-renew and persist, then it still remains important to understand at what point do these populations acquire mutations that result in the onset of disease.

To me, this becomes a game of statistics: calling all bio-statisticians to the front. If cancer really is “random,” then I think we need large-scale genetic screens within our population to obtain genetic profiles that contribute to increased risk of cancer.

Scientists finished sequencing the human genome over a decade ago and since then, the cost of getting your own individual genetic screen has dropped to where patients’ out-of-pocket costs are about $100, depending on the nature of the test. Should genetic testing then become a part of your annual physical? I would argue that it should. Early detection is the key to surviving the majority of cancers!

Would you pay for genetic screening?

Megan Cooley, Ph.D., is a postdoctoral fellow at the University of Kansas Medical Center. Her research is focused on understanding the effects of the tumor microenvironment on acquired chemoresistance and metastasis.