User:CharlotteLucas/sandbox

Editing under the Wikipedia page: Cancer Syndrome

New title: Genetic Screening.

The process itself of genetic screening is generally a simple non-invasive procedure. However, before genes are tested for mutations the patient usually has to go to a health care provider and has to go through a one on one consultation where they both discuss both the personal and family history of cancer, the medical professional can then assess the likelihood of the patient having the mutation and can guide them through the process that is genetic screening [32]. It’s important that this consultation takes place because it makes sure that the person gives informed consent to engage in genetic testing, is aware and understands the steps, benefits and limitations of the procedure and is more knowledgeable of the consequences of hearing test results [33]. The test can be done by using body fluids or tissues of the patient, this includes blood (which is the most common), saliva, amniotic fluid and even cells from the inside of the check gotten from a buccal swab; this material is then sent to a specialised genetic lab where technicians will examine it, the test results usually are sent back to the health provider who requested the analysis and results are discussed with the patient [27]. Direct to consumer testing can be gotten without a medical professional but isn’t recommended as the consumer loses the opportunity talk about their decision with an educated professional [34]. According the U.S. National Library of Medicine genetic testing in America costs in the price range of $100-$2000 depending on the type and intricacy of test [35]. Further reports state that the pre-test consultations and preliminary testing although seem expensive in the short term are actually more cost effective in the long run [36].

32.	Foulkes, William D., et al. “Population Genetic Testing for Cancer Susceptibility: Founder Mutations to Genomes.” Nature Reviews Clinical Oncology, vol. 13, no. 1, 2015, pp. 41–54. 33.	“How Is Genetic Testing Done? - Genetics Home Reference.” U.S. National Library of Medicine, National Institutes of Health. 34.	Myers, Melanie F., and Barbara A. Bernhardt. “Direct-to-Consumer Genetic Testing: Introduction to the Special Issue.” Journal of Genetic Counseling, vol. 21, no. 3, 2012, pp. 357–360. 35.	“What Is the Cost of Genetic Testing, and How Long Does It Take to Get the Results? - Genetics Home Reference.” U.S. National Library of Medicine, National Institutes of Health. 36.	Mvundura, Mercy, et al. “The Cost-Effectiveness of Genetic Testing Strategies for Lynch Syndrome among Newly Diagnosed Patients with Colorectal Cancer.” Genetics in Medicine, vol. 12, no. 2, 2009, pp. 93–104.

New Title: Genetic cancers in different races

Often genetic mutations are more common in certain ethnic groups compared to others, this is because a race can usual track their ancestors back to one geographic location, the mutated genes are then passed from ancestors down through generations which is why some ethnicities are more susceptible to mutations increasing their chances of developing cancer [36]. As mentioned above this can be useful as it can help health professionals assess a patient’s risk of having a mutation before they undergo screening [32]. WS a syndrome dissected above caused by a gene mutation has a prevalence of 1 in 200,000 people in the U.S. but it affects individuals in Japan in 1 in 20,000-40,000 cases [38]. Results of a study published in the Stanford report in 2008, on BCRA 1, one of the two main genetic mutations causing a predisposition to HBOC shows that there’s a contrast between different ethnic groups. 0.5% of cancer cases were caused by a mutation in the BRCA1 gene for Asian Americans whereas a huge 8.3% of cancer cases in the Ashkenazi Jewish population was caused by the BRCA1 mutation [39]. This is a stark contrast and backs up the idea that genetic mutations are more prevalent in some races. Another study (including both BRCA 1 and 2 mutations) back up the previous report showed that 1 in 40 Ashkenazi Jews had the mutation this is 10 times greater than the general U.S. population which is 1 in 400 people [40].

36.	Mvundura, Mercy, et al. “The Cost-Effectiveness of Genetic Testing Strategies for Lynch Syndrome among Newly Diagnosed Patients with Colorectal Cancer.” Genetics in Medicine, vol. 12, no. 2, 2009, pp. 93–104. 37.	“Why Are Some Genetic Conditions More Common in Particular Ethnic Groups? - Genetics Home Reference.” U.S. National Library of Medicine, National Institutes of Health. 38.	“Werner Syndrome - Genetics Home Reference.” U.S. National Library of Medicine, National Institutes of Health. 39.	Adams, Amy. “Study Tracks Breast Cancer Gene in Racial Groups.” Stanford University, 9 Jan. 2008. 40.	James, Mia. “Genetic Risk, Race and Ethnicity | Cancer Fighters Thrive Magazine.”CancerCenter.com, 29 May 2014.

New Title: Gene Editing

CRISPR Cas9 genome editing is shaping the future of research in cancer today, CRISPR stands for clustered regularly interspaced short palindromic repeats and Cas9 stands for CRISPR associated genes; they both allow the human genome to be read and edited at a high speed [41]. Cancer can develop as a result of both germline mutations as discussed above in the second paragraph and acquired mutations during a person’s lifespan [42]. It’s the germline mutations that are associated with hereditary forms of cancer as it is an innate mutation passed from one generation to another [7]. CRISPR has potential to decrease prevalence of cancer syndromes but many people question its efficacy, safety and morality [43]. An example of CRISPR working with an inherited cancer can be seen in a series of experiment carried out by researchers in Utrecht university located in the Netherlands, firstly by studying genes in a tumour they identified the gene NTHL1, secondly using CRISPR cas9 they were able to turn off that specific gene and deduced by simply looking at genes in a tumour that a mutation in the NTHL1 gene was a cause of HNPCC and they were able to disable a gene singly to stop the active mutation taking effect, which would usually increase a person’s chance of developing cancer in their lifespan compared to the general population [44]. This study was ground breaking, because if they’re able to do that, when and where will they stop?

41.	Ma, Yuanwu, et al. “Genome Modification by CRISPR/Cas9.” FEBS Journal, vol. 281, no. 23, 2014, pp. 5186–5193. 42.	Chen, Si, et al. “CRISPR-Cas9: from Genome Editing to Cancer Research.” International Journal of Biological Sciences, vol. 12, no. 12, 2016, pp. 1427–1436. 43.	Evitt, Niklaus H., et al. “Human Germline CRISPR-Cas Modification: Toward a Regulatory Framework.” The American Journal of Bioethics, vol. 15, no. 12, 2015, pp. 25–29. 44.	Kassam, Zara. “CRISPR-Cas9 Technology Used to Study Hereditary Forms of Cancer.” Drug Target Review, 14 Sept. 2017.