Ethnic differences in cancer risk resulting from genetic variation.

Ethnic differences in cancer incidence and mortality exist and are probably the result of genetic and epidemiological risk factors. Genetic differences caused by founder mutations are reviewed, with special emphasis on mutations in BRCA1 and BRCA2. Germline mutations in cancer susceptibility genes have been identified in individuals of all races and ethnic groups. Differences among ethnic groups for cancer risks have been recognized, and a proportion of the differences may be the result of founder mutations within these genes. The BRCA2 999del5 mutation in Iceland and the three BRCA1 and BRCA2 mutations in Ashkenazic Jews have been well characterized and were easy to study because the patient population and anonymous samples were readily available and ethnicity was known. Mutations in BRCA1 and BRCA2 probably account for approximately 3 to 10% of breast cancer in the general population and a much higher proportion in those with a strong family history of breast and ovarian cancers and in those of Ashkenazic Jewish descent. However, no overall increased risk of breast or ovarian cancers exists among Ashkenazic Jewish women compared with non-Jewish Caucasians. Some ethnic variation in cancer risk may be explained by founder mutations identified in cancer-predisposing genes. Knowledge acquired by studying the effect of a single mutation in a well defined population may be applied to larger, more heterogeneous populations. Individuals from all racial and ethnic groups carry deleterious mutations. Mutations are simply easier to find and characterize when identified in a specific ethnic group.