Is there a genetic link between parental pancreatic cancer, lung cancer, and breast cancer in children?

From the Guidelines

There is a genetic link between parental pancreatic, lung, and breast cancers and increased cancer risk in children, with genes such as BRCA1, BRCA2, PALB2, ATM, CDKN2A, and TP53 playing a significant role in this increased risk. Children of parents with these cancers may inherit genetic mutations that increase their own cancer susceptibility. The most well-known genes involved include BRCA1 and BRCA2, which significantly increase breast cancer risk but also affect pancreatic cancer risk 1. Other relevant genes include PALB2, ATM, CDKN2A, and TP53. Families with Lynch syndrome (hereditary nonpolyposis colorectal cancer) also face increased risk for multiple cancer types.

Key Genes Involved

• BRCA1 and BRCA2: significantly increase breast cancer risk and also affect pancreatic cancer risk 1
• PALB2, ATM, CDKN2A, and TP53: also play a role in increasing cancer risk
• Genes associated with Lynch syndrome: increase risk for multiple cancer types

Recommendations

• Consider genetic counseling and testing if you have a family history of these cancers, which typically involves a simple blood or saliva sample 1
• Testing can identify specific mutations and help determine appropriate screening protocols
• For those with confirmed genetic predisposition, enhanced surveillance may include earlier and more frequent mammograms, breast MRIs, pancreatic imaging, or lung scans depending on the specific mutation identified 1

Importance of Genetic Testing

Genetic testing can help identify individuals who are at high risk of developing cancer, allowing for early intervention and potentially improving outcomes. As stated in the NCCN Guidelines for Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, version 2.2021, carriers of a BRCA1/2 pathogenic or likely pathogenic variant have an excessive risk for both breast and ovarian cancer that warrants consideration of more intensive screening and preventive strategies 1.

From the Research

Genetic Link Between Parental Cancers and Cancer in Children

• There is evidence to suggest a genetic link between parental pancreatic cancer, lung cancer, and breast cancer in children 2, 3, 4, 5, 6.
• Studies have shown that inherited predisposition to pancreas cancer accounts for approximately 10% of cases, and familial aggregation may be influenced by shared environmental factors and shared genes 3.
• A family history of pancreas cancer has been associated with a doubled risk of lymphoma and ovarian cancer among relatives, and a sevenfold increased risk of lymphoma among relatives with a family history of early-onset pancreas cancer 3.
• BRCA1 and BRCA2 mutations have been linked to an increased risk of pancreatic cancer, as well as breast and ovarian cancer 2, 4.
• Approximately 10% of all children with cancer are affected by a monogenic cancer predisposition syndrome, highlighting the importance of assessing hereditary cancer predisposition in children with cancer 5.
• Genetic and familial factors can influence the risk of breast, colon, prostate, and lung cancers, and genetic testing and counseling can be helpful in identifying a hereditary cancer predisposition gene or establishing a cancer risk management plan 6.

Specific Cancers and Genetic Links

• Pancreatic cancer: linked to BRCA1 and BRCA2 mutations, as well as other genetic syndromes such as hereditary pancreatitis and familial atypical mole and multiple melanoma 2.
• Lung cancer: may be influenced by shared environmental factors and shared genes, and a family history of lung cancer can increase an individual's personal risk of developing the disease 3, 6.
• Breast cancer: linked to BRCA1 and BRCA2 mutations, and a family history of breast cancer can increase an individual's personal risk of developing the disease 2, 4, 6.