Campaign on the importance of early detection of colon cancer (preventive order)
A new study led by Rambam Medical College researchers, the findings of which are now being published in the international journal - Digestive and Liver Disease, shows that there is a high prevalence of cases of hereditary polyposis syndrome among Arabs and Druze in the north of the country with multiple polyps in the large intestine. The study shows that mutations in the MUTYH gene
associated The hereditary syndrome - MUTYH Associated Polyposis (or by its abbreviated name - MAP syndrome) causes about 27% of the cases of polyposis patients, in the Arab and Druze population in northern Israel. "This is a finding of great importance for the relevant population," the researchers explain, "the information will make it possible to locate families who are at increased risk of colon cancer and to adapt follow-up and prevention programs to them."
Every year about 3000 new patients are diagnosed in Israel
Colorectal cancer is the second most common cancer, with approximately 3,000 new patients diagnosed in Israel each year, according to the data of the Cancer Society.
According to the data, colon cancer is the second most common cause of death among all cancer deaths, regardless of gender, in Jews and Arabs.
"Colon cancer begins with polyps (benign - pre-cancerous growths) that develop in the colon," explains Dr. Elizabeth Helf, director of the unit for the detection and prevention of gastrointestinal malignancies, and the multidisciplinary center for early detection and prevention of cancer at Rambam Medical College, who led the study. "Gastroenterological follow-up and colonoscopy tests allow the detection of polyps in the pre-cancerous stage and their removal if possible or the referral of the patient to surgery, thus preventing the development of cancer. These processes translate into saving lives in high percentages."
The second most common cause of death among all cancer deaths (Photo: ShutterStock)
Gili Raznik Levy, senior genetic counselor, and in charge of the field of oncogenetics at the Rambam Genetics Institute, who led the research together with Dr. Helf, explains that about 10% to 20% of colon cancer cases are due to a hereditary genetic background.
Conditions associated with multiple polyps in the colon raise the suspicion of a mutation in another of the genes associated with hereditary polyposis syndromes.
"One of these syndromes is the MAP syndrome," Reznik Levy points out, "the uniqueness of this syndrome compared to other hereditary cancer syndromes is the form of inheritance. This syndrome is inherited in an autosomal recessive manner, meaning that mutations are required in both copies of the gene (one from the mother and one from the father) in order for it to be expressed The syndrome. The risk of hereditary conditions in this inheritance increases significantly when there is a close relationship between the parents."
Patients are getting younger
According to Dr. Karin Weiss, Director of the Rambam Genetics Institute, this syndrome accounts for approximately 6% of colon cancer cases at a young age, when the scientific and medical community has known for many years that mutations in this gene are common in the European population as well as in the Jewish population of North Africa in Israel .
However, so far no research has been carried out on this syndrome in the Arab population in Israel.
"Our assessment was that, in light of the relatively high rate of consanguineous marriages, we found a high prevalence of this syndrome in the population treated at Rambam - that is, in the Arab and Druze population in the Galilee," emphasizes Dr. Weiss, who is also on the staff of the Institute for Medical Research at Rambam
. It emerged from the results of the study: out of 37 patients with polyposis with or without colon cancer, from 30 different families, 8 families (27%) had biallelic mutations (mutations in both copies) of the MUTYH gene.
"We also collaborated with four other medical centers that treat polyposis patients - Rabin Medical Center, Hadassah Hospital, Soroka and Sheba - and together we collected the genetic information on patients with MAP syndrome from the Arab sector in Israel," adds Reznik Levy and explains the uniqueness of the findings, "We found Because the mutations found in these families are different from the mutations known in the general population and the Jewish population in Israel.
In addition, we saw that in these families the age of colon cancer incidence was really young.
An average age of 38 years, which is a decade lower than what is reported in the medical literature among families with MAP syndrome."
Another important finding that was discovered as part of the study is that there is one particular mutation that is responsible for most cases in these families. "This finding makes it possible to carry out an easy, accurate, fast and cheap genetic diagnosis to detect individuals with MAP syndrome in this population," says Dr. Weiss, "
However, while the results of the study shed light on the processes by which the disease developed among certain risk groups, the main importance is in the follow-up and early detection processes.
"Patients with MAP syndrome who do not perform the necessary follow-up colonoscopy have a very high risk of up to 80% of developing colon cancer during their lifetime," warns Dr. Helf, "this risk can be avoided if regular colonoscopy examinations are performed at a young age, starting at age 20-25 years".
According to the researchers' assessment, in some villages in the Galilee region there is, apparently, a high incidence of MAP syndrome.
"The next step of the research will be to check the prevalence of mutts in these villages also among healthy individuals," they point out, "If a high prevalence is found, it may be appropriate to offer genetic testing to the entire adult population in the villages at risk. It is important for us to have awareness of this syndrome in the Arab and Druze population of the Galilee which is at risk. Both among the general public and among the treating factors, gastroenterologists and family doctors, who are tasked with following the warning signs, and referring the relevant patients to genetic counseling for the purpose of early detection and even prevention of cancer."
health
news
Tags
Druze
Colorectal Cancer
cancer