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Valle L, Katz LH, Latchford A, Mur P, Moreno V, Frayling IM, Heald B, Capellá G. Position statement of the International Society for Gastrointestinal Hereditary Tumours (InSiGHT) on APC I1307K and cancer risk. J Med Genet 2023; 60:1035-1043. [PMID: 37076288 PMCID: PMC10646901 DOI: 10.1136/jmg-2022-108984] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/01/2023] [Indexed: 04/21/2023]
Abstract
While constitutional pathogenic variants in the APC gene cause familial adenomatous polyposis, APC c.3920T>A; p.Ile1307Lys (I1307K) has been associated with a moderate increased risk of colorectal cancer (CRC), particularly in individuals of Ashkenazi Jewish descent. However, published data include relatively small sample sizes, generating inconclusive results regarding cancer risk, particularly in non-Ashkenazi populations. This has led to different country/continental-specific guidelines regarding genetic testing, clinical management and surveillance recommendations for I1307K. A multidisciplinary international expert group endorsed by the International Society for Gastrointestinal Hereditary Tumours (InSiGHT), has generated a position statement on the APC I1307K allele and its association with cancer predisposition. Based on a systematic review and meta-analysis of the evidence published, the aim of this document is to summarise the prevalence of the APC I1307K allele and analysed the evidence of the associated cancer risk in different populations. Here we provide recommendations on the laboratory classification of the variant, define the role of predictive testing for I1307K, suggest recommendations for cancer screening in I1307K heterozygous and homozygous individuals and identify knowledge gaps to be addressed in future research studies. Briefly, I1307K, classified as pathogenic, low penetrance, is a risk factor for CRC in individuals of Ashkenazi Jewish origin and should be tested in this population, offering carriers specific clinical surveillance. There is not enough evidence to support an increased risk of cancer in other populations/subpopulations. Therefore, until/unless future evidence indicates otherwise, individuals of non-Ashkenazi Jewish descent harbouring I1307K should be enrolled in national CRC screening programmes for average-risk individuals.
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Affiliation(s)
- Laura Valle
- Hereditary Cancer Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Lior H Katz
- Department of Gastroenterology and Hepatology, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Andrew Latchford
- The Polyposis Registry, St Mark's Hospital, London North West University Healthcare NHS Trust, Harrow, UK
- Department of Surgery and Cancer, Imperial College, London, UK
| | - Pilar Mur
- Hereditary Cancer Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
- Catalan Cancer Plan, Department of Health of Catalonia, Barcelona, Spain
| | - Victor Moreno
- Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
- Oncology Data Analytics Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Universitat de Barcelona Institute of Complex System (UBICS), University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ian M Frayling
- Inherited Tumour Syndromes Research Group, Cardiff University, Cardiff, Wales, UK
| | - Brandie Heald
- Sanford R. Weiss MD Center for Hereditary Colorectal Neoplasia, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gabriel Capellá
- Hereditary Cancer Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
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Hoption Cann SA, Qiu Z, van Netten C. A Prospective Study of Iodine Status, Thyroid Function, and Prostate Cancer Risk: Follow-up of the First National Health and Nutrition Examination Survey. Nutr Cancer 2007; 58:28-34. [PMID: 17571964 DOI: 10.1080/01635580701307960] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Few studies have investigated the association between iodine status, thyroid disease, and cancer risk despite evidence that thyroid function impacts many organs, including the prostate. We investigated iodine status and prostate cancer risk prospectively using data from the NHANES I Epidemiologic Follow-up Study. Participants were stratified into tertiles according to the urinary iodine/creatinine ratio, as a marker of iodine exposure. As iodine is an integral constituent of thyroid hormones, we also examined the relationship between thyroid disease and prostate cancer risk. Relative to the group with low urinary iodine, the age-adjusted hazard ratio was higher (although marginally insignificant) in the moderate group, hazard ratio 1.33 (95% confidence interval 1.00-1.78), and significantly lower in the high group, 0.71 (0.51-0.99). Thyroid disease was associated with an increased prostate cancer risk, 2.34 (1.24-4.43). Similarly, > 10 yr since thyroid disease diagnosis was associated with an elevated risk, 3.38 (1.66-6.87). After adjusting for other confounding factors, only a history of thyroid disease, 2.16 (1.13-4.14), and > 10 yr since diagnosis of thyroid disease, 3.17 (1.54-6.51) remained significant. Although the role of dietary iodine remains speculative, a role for thyroid disease and/or factors contributing to thyroid disease as a risk factor for prostate carcinogenesis warrants additional investigation.
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Affiliation(s)
- Stephen A Hoption Cann
- Department of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, Canada.
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Cheng RYS, Hockman T, Crawford E, Anderson LM, Shiao YH. Epigenetic and gene expression changes related to transgenerational carcinogenesis. Mol Carcinog 2004; 40:1-11. [PMID: 15108325 DOI: 10.1002/mc.20022] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Transgenerational carcinogenesis refers to transmission of cancer risk to the untreated progeny of parents exposed to carcinogens before mating. Accumulated evidence suggests that the mechanism of this process is epigenetic, and might involve hormonal and gene expression changes in offspring. To begin to test this hypothesis, we utilized a mouse model (NIH Swiss) in which exposure of fathers to Cr(III) chloride 2 wk before mating can alter incidence of neoplastic and nonneoplastic changes in offspring tissues. Utilizing a MS-RDA approach, we found that the sperm of these fathers had a significantly higher percentage of undermethylated copies of the 45S ribosomal RNA gene (rRNA); this finding was confirmed by bisulfite sequencing. Because gene methylation is a known mechanism of expression control in germ cells, and ribosomal RNA levels have been linked to cancer, these findings are consistent with the hypothesis. Secondly, we observed that offspring of Cr(III)-treated fathers were significantly heavier than controls, and had higher levels of serum T3. Possible effects of T3 levels on gene expression in the offspring were examined by microarray analysis of cDNAs from liver. A total of 58 genes, including 25 named genes, had expression ratios that correlated significantly with serum T3 ratios at P </= 0.001. Some of these genes have potential roles in growth and/or tumor suppression. These results also support the hypothesis of an epigenetic and/or gene expression-based mechanism for transgenerational carcinogenesis. Published 2004 Wiley-Liss, Inc.
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Affiliation(s)
- Robert Y-S Cheng
- Laboratory of Comparative Carcinogenesis, National Cancer Institute at Frederick, Frederick, Maryland 21702, USA
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