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UPMC Cancer Centers Establishes Program For Individuals And Families At High-Risk For Colorectal Cancer

PITTSBURGH, July 21, 2004 Colorectal cancer is newly diagnosed in more than 130,000 men and women each year and is the second-leading cause of cancer deaths in the United States. While most colorectal cancers occur in people over the age of 50 and are not related to hereditary factors, colorectal cancer that occurs in someone under the age of 50 or a cluster of cancers within the same family may be a sign of a hereditary condition.

To help identify families who may be at greater risk for colorectal cancer and to start screening them earlier, the UPMC Cancer Centers has established the Hereditary Colorectal Tumor Program. The program was developed to serve high-risk patients and their families by offering risk assessment, genetic counseling, prevention programs, clinical trials and a full range of treatment options.

"People who have a family history of colorectal cancer have about twice the risk of developing the disease compared to the general population," said Linda Farkas, M.D., clinical director, Hereditary Colorectal Tumor Program, and assistant professor of surgery, division of surgical oncology, University of Pittsburgh School of Medicine. "By identifying individuals and families at high risk for colorectal cancer, we can start their screening earlier, follow them more closely and treat them as soon as they show evidence of disease. Early treatment, in turn, may translate to a lower mortality rate in this group."

The most common form of hereditary colon cancer, hereditary nonpolyposis colorectal cancer or HNPCC, is responsible for 3 to 5 percent of all colorectal cancers and is associated with a 60 percent risk of endometrial cancer and a greatly increased risk of other less common diseases, including ovarian and gastric cancers. HNPCC is primarily caused by an inherited mutation in either of two genes, MLH1 and MLH2.

"Half of the children of people who inherit a mutation in MLH1 and MLH2 will inherit one of these mutations themselves," said Dr. Farkas. "By using risk assessment strategies, preventive measures and a full range of diagnostic methods, our program will provide an opportunity to prevent cancer and improve quality of life for those at the greatest risk of developing colorectal cancer," she added.

The program will serve individuals with a personal or family history of colorectal or endometrial cancer diagnosed before the age of 50; families with multiple generations affected by colorectal cancer; men and women of Ashkenazi Jewish decent with colorectal cancer; individuals with multiple cancers (colon and ovarian or more than one colon cancer); men and women with a personal or family history of HNPCC; and first-degree relations of those who may be a genetic carrier of colorectal cancer.

In addition to Dr. Farkas, who is a colon and rectal surgeon, the clinical program staff includes a specialist in gynecologic oncology, Joseph Kelley, M.D., and two genetic counselors, Darcy Thull, M.S., and Dana Farengo-Clark, M.S. Other program staff includes a pathologist and three basic science researchers. Clinical program staff members coordinate contact among family members and their physicians as well as provide information about cancer risk, screening and genetic testing.

For more information on the Hereditary Colorectal Tumor Program, individuals should call the University of Pittsburgh Medical Center's 24-hour physician referral service at 412-692-2400 or 1-866-884-8579.

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