Each year in the United States, there are over 230,000 newcases of prostate cancer and almost 28,000 deaths. A 3.8-Mbregion on chromosome 8 (8q24), called a gene desert, has genes but contains enhancer sequences that potentiallyconfer significant risks for prostate cancer. One particular enhancerallele, which is known to be associated with an elevated risk forprostate cancer, physically interacts with the promoter region ofthe nearby MYC gene and facilitates its upregulation. Overexpressionof MYC, which encodes a cell-cycle regulatory protein, isobserved in multiple types of cancer (see Chapter 24). The riskallele has a frequency of 49 percent in men of European descentand 81 percent in men of African ancestry. Most of the differentialMYC activity associated with the risk allele occurs during prenataldevelopment, raising the possibility that testing for this alleleearly in life can be used to identify those in the African-Americanpopulation who are at very high risk for prostate cancer. However,researchers cannot rule out the possibility that this enhancer causes overexpression of other genes, which may also be involvedin prostate cancer. If a screening test for the risk allele is developed, the test could show that the risk allele is not present, and MYC activity would be normal. However, someone can receive a negative result from this test but still have a higher than normal risk for prostate cancer from other mutations that contribute to cancer risk. What ethical concerns are there with using a test for cancer susceptibility that is focused on only one risk allele?
Each year in the United States, there are over 230,000 new
cases of prostate cancer and almost 28,000 deaths. A 3.8-Mb
region on chromosome 8 (8q24), called a gene desert, has genes but contains enhancer sequences that potentially
confer significant risks for prostate cancer. One particular enhancer
allele, which is known to be associated with an elevated risk for
prostate cancer, physically interacts with the promoter region of
the nearby MYC gene and facilitates its upregulation. Overexpression
of MYC, which encodes a cell-cycle regulatory protein, is
observed in multiple types of cancer (see Chapter 24). The risk
allele has a frequency of 49 percent in men of European descent
and 81 percent in men of African ancestry. Most of the differential
MYC activity associated with the risk allele occurs during prenatal
development, raising the possibility that testing for this allele
early in life can be used to identify those in the African-American
population who are at very high risk for prostate cancer. However,
researchers cannot rule out the possibility that this enhancer causes overexpression of other genes, which may also be involved
in prostate cancer. If a screening test for the risk allele is developed, the test
could show that the risk allele is not present, and MYC activity
would be normal. However, someone can receive a negative
result from this test but still have a higher than normal risk for
prostate cancer from other mutations that contribute to cancer
risk. What ethical concerns are there with using a test for cancer
susceptibility that is focused on only one risk allele?
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