Lung cancer genetics
Is lung cancer a hereditary cancer?
Inherited mutations alone are not thought to cause very many lung cancers.
Still, inherited gene mutations do seem to play a role in some families with a history of lung cancer. For example, people who inherit certain DNA changes in chromosome 6 are more likely to develop lung cancer, even if they don’t smoke or only smoke a little.
Some people seem to inherit a reduced ability to break down or get rid of certain types of cancer-causing chemicals in the body, such as those found in tobacco smoke. This could put them at higher risk for lung cancer.
Other people inherit faulty DNA repair mechanisms that make it more likely they will end up with DNA changes might be especially vulnerable to cancer-causing chemicals and radiation.
Some non-small cell lung cancers (NSCLCs) make too much EGFR protein which comes from an abnormal EGFR gene. This is seen more often with adenocarcinoma of the lung in young, non-smoking, Asian women, but the excess EGFR protein has also been seen in more than 60 percent of metastatic NSCLCs.
Source: “What Causes Lung Cancer?” (American Cancer Society, 2019)
Other genes involved in lung cancer
Gene mutations related to lung cancer are usually acquired during a person’s lifetime rather than inherited and often result from exposure to factors in the environment, such as cancer-causing chemicals in tobacco smoke. But some gene changes may just be random events that sometimes happen inside a cell, without having an outside cause.
Acquired changes in certain genes, such as the RB1 tumor suppressor gene, are thought to be important in the development of small cell lung cancer.
Acquired changes in genes such as the p16 tumor suppressor gene and the K-RAS oncogene, are thought to be important in the development of non-small cell lung cancers, the most common kind. Changes in the TP53 tumor suppression gene and to chromosome 3 can be seen in both non-small cell lung cancers and small cell lung cancer.
Source: “What Causes Lung Cancer?” (American Cancer Society, 2019)
Lung genes in non-smokers with lung cancer
Disparities in lung cancer genetics?
About 5% to 10% of breast cancer cases are thought to be hereditary, meaning that they result directly from gene changes (mutations) passed on from a parent. The most common cause of hereditary breast cancer is an inherited mutation in the BRCA1 or BRCA2 gene.
Recent news about disparities in genetic mutations
Lung cancer genetic testing
Get Genetic Counseling Before Testing
How is genetic testing done?
Susan G. Komen says its “My Family Health Portrait” is an internet-based tool that’s easy to access on the web and simple to fill out and should only take about 15 to 20 minutes to build a basic family health history. It assembles your information and makes a “pedigree” family tree that you can download and share with family members or send to your health care practitioner. It is private–it does not keep your information.
Genetic testing after a lung cancer diagnosis
Paying for genetic testing
Insurance coverage for genetic counseling and testing
Most health plans cover genetic counseling and testing for inherited gene mutations linked to cancer in people who meet the national guidelines. The cost of testing and your out-of-pocket charges may vary based on several factors. People who are denied coverage for genetic testing can file an appeal (FORCE has sample appeal letters). About half of appeals are approved.
Medicare and Medicaid
Genetic counseling and testing is typically covered by Medicare for people already diagnosed with cancer who are in treatment or for whom test results may affect their care. Most state Medicaid programs cover genetic testing for BRCA and Lynch Syndrome mutations for people who meet requirements, which vary by state. You can read more about Medicare and Medicaid coverage of genetic testing here.
Financial assistance or low cost genetic testing
JScreen is a national program based out of Emory University in Atlanta that provides discounted at-home genetic counseling and testing with financial assistance available. Many laboratories offer low-cost genetic testing or financial assistance programs. Programs vary, so if you are not eligible for assistance through one lab, consider contacting other labs to see if you qualify. For more information, see “Paying for Care” on the FORCE website.
Disparities in lung cancer genetic testing?
Racial Disparities Persist in Genetic Testing
About 5% to 10% of breast cancer cases are thought to be hereditary, meaning that they result directly from gene changes (mutations) passed on from a parent. The most common cause of hereditary breast cancer is an inherited mutation in the BRCA1 or BRCA2 gene.