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Ait Ouakrim D, Dashti SG, Chau R, Buchanan DD, Clendenning M, Rosty C, Winship IM, Young JP, Giles GG, Leggett B, Macrae FA, Ahnen DJ, Casey G, Gallinger S, Haile RW, Le Marchand L, Thibodeau SN, Lindor NM, Newcomb PA, Potter JD, Baron JA, Hopper JL, Jenkins MA, Win AK. Aspirin, Ibuprofen, and the Risk of Colorectal Cancer in Lynch Syndrome. J Natl Cancer Inst 2015; 107:djv170. [PMID: 26109217 DOI: 10.1093/jnci/djv170] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 05/22/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Inheritance of a germline mutation in one of the DNA mismatch repair (MMR) genes MLH1, MSH2, MSH6, and PMS2 causes a high risk of colorectal and other cancers (Lynch Syndrome). Use of aspirin has been shown to be associated with a reduced risk of colorectal cancer for the general population as well as for MMR gene mutation carriers. The aim of this study was to determine whether use of aspirin and ibuprofen in a nontrial setting is associated with the risk of colorectal cancer risk for MMR gene mutation carriers. METHODS We included 1858 participants in the Colon Cancer Family Registry who had been found to have a pathogenic germline mutation in a MMR gene (carriers). We used weighted Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. RESULTS A total of 714 carriers (38%) were diagnosed with colorectal cancer at a mean age of 42.4 (standard deviation 10.6) years. A reduced risk of colorectal cancer was associated with aspirin use (for 1 month to 4.9 years: HR = 0.49, 95% CI = 0.27 to 0.90, P = .02; for ≥5 years: HR = 0.25, 95% CI = 0.10 to 0.62, P = .003) and ibuprofen use (for 1 month to 4.9 years: HR = 0.38, 95% CI = 0.18 to 0.79, P = .009; for ≥5 years: HR = 0.26, 95% CI = 0.10 to 0.69, P = .007), compared with less than one month of use. CONCLUSION Our results provide additional evidence that, for MMR gene mutation carriers, use of aspirin and ibuprofen might be effective in reducing their high risk of colorectal cancer.
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Affiliation(s)
- Driss Ait Ouakrim
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Seyedeh Ghazaleh Dashti
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Rowena Chau
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Daniel D Buchanan
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Mark Clendenning
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Christophe Rosty
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Ingrid M Winship
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Joanne P Young
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Graham G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Barbara Leggett
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Finlay A Macrae
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Dennis J Ahnen
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Graham Casey
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Steven Gallinger
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Robert W Haile
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Loïc Le Marchand
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Stephen N Thibodeau
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Noralane M Lindor
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Polly A Newcomb
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - John D Potter
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - John A Baron
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Mark A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
| | - Aung Ko Win
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia (DAO, SGD, RC, DDB, GGG, JLH, MAJ, AKW); Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia (DDB, MC, CR); University of Queensland, School of Medicine, Herston, Queensland, Australia (CR); Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia (IMW, FAM); Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia (IMW, FAM); Departments of Haematology and Oncology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia (JPY); SAHMRI Colorectal Node, Basil Hetzel Institute for Translational Research, Woodville, South Australia, Australia (JPY); School of Medicine, University of Adelaide, South Australia, Australia (JPY); Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia (GGG); QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Queensland, Australia (BL); Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia (FAM); Department of Medicine, University of Colorado School of Medicine, Denver, CO (DJA); Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA (GC); Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (SG); Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA (RWH); University of Hawaii Cancer Center, Honolulu, HI (LLM); Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN (SNT); Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ (NML); Public Health Science
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Palles C, Chegwidden L, Li X, Findlay JM, Farnham G, Castro Giner F, Peppelenbosch MP, Kovac M, Adams CL, Prenen H, Briggs S, Harrison R, Sanders S, MacDonald D, Haigh C, Tucker A, Love S, Nanji M, deCaestecker J, Ferry D, Rathbone B, Hapeshi J, Barr H, Moayyedi P, Watson P, Zietek B, Maroo N, Gay L, Underwood T, Boulter L, McMurtry H, Monk D, Patel P, Ragunath K, Al Dulaimi D, Murray I, Koss K, Veitch A, Trudgill N, Nwokolo C, Rembacken B, Atherfold P, Green E, Ang Y, Kuipers EJ, Chow W, Paterson S, Kadri S, Beales I, Grimley C, Mullins P, Beckett C, Farrant M, Dixon A, Kelly S, Johnson M, Wajed S, Dhar A, Sawyer E, Roylance R, Onstad L, Gammon MD, Corley DA, Shaheen NJ, Bird NC, Hardie LJ, Reid BJ, Ye W, Liu G, Romero Y, Bernstein L, Wu AH, Casson AG, Fitzgerald R, Whiteman DC, Risch HA, Levine DM, Vaughan TL, Verhaar AP, van den Brande J, Toxopeus EL, Spaander MC, Wijnhoven BPL, van der Laan LJW, Krishnadath K, Wijmenga C, Trynka G, McManus R, Reynolds JV, O'Sullivan J, MacMathuna P, McGarrigle SA, Kelleher D, Vermeire S, Cleynen I, Bisschops R, Tomlinson I, Jankowski J. Polymorphisms near TBX5 and GDF7 are associated with increased risk for Barrett's esophagus. Gastroenterology 2015; 148:367-78. [PMID: 25447851 PMCID: PMC4315134 DOI: 10.1053/j.gastro.2014.10.041] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 10/19/2014] [Accepted: 10/21/2014] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS Barrett's esophagus (BE) increases the risk of esophageal adenocarcinoma (EAC). We found the risk to be BE has been associated with single nucleotide polymorphisms (SNPs) on chromosome 6p21 (within the HLA region) and on 16q23, where the closest protein-coding gene is FOXF1. Subsequently, the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) identified risk loci for BE and esophageal adenocarcinoma near CRTC1 and BARX1, and within 100 kb of FOXP1. We aimed to identify further SNPs that increased BE risk and to validate previously reported associations. METHODS We performed a genome-wide association study (GWAS) to identify variants associated with BE and further analyzed promising variants identified by BEACON by genotyping 10,158 patients with BE and 21,062 controls. RESULTS We identified 2 SNPs not previously associated with BE: rs3072 (2p24.1; odds ratio [OR] = 1.14; 95% CI: 1.09-1.18; P = 1.8 × 10(-11)) and rs2701108 (12q24.21; OR = 0.90; 95% CI: 0.86-0.93; P = 7.5 × 10(-9)). The closest protein-coding genes were respectively GDF7 (rs3072), which encodes a ligand in the bone morphogenetic protein pathway, and TBX5 (rs2701108), which encodes a transcription factor that regulates esophageal and cardiac development. Our data also supported in BE cases 3 risk SNPs identified by BEACON (rs2687201, rs11789015, and rs10423674). Meta-analysis of all data identified another SNP associated with BE and esophageal adenocarcinoma: rs3784262, within ALDH1A2 (OR = 0.90; 95% CI: 0.87-0.93; P = 3.72 × 10(-9)). CONCLUSIONS We identified 2 loci associated with risk of BE and provided data to support a further locus. The genes we found to be associated with risk for BE encode transcription factors involved in thoracic, diaphragmatic, and esophageal development or proteins involved in the inflammatory response.
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Affiliation(s)
- Claire Palles
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
| | - Laura Chegwidden
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, Devon, UK
| | - Xinzhong Li
- Centre of Biostatistics, Bioinformatics and Biomarkers, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, Devon, UK
| | - John M Findlay
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Garry Farnham
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, Devon, UK
| | | | - Maikel P Peppelenbosch
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Michal Kovac
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Claire L Adams
- Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, Devon, UK
| | - Hans Prenen
- Department of Digestive Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Sarah Briggs
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Rebecca Harrison
- Department of Pathology, Leicester Royal Infirmary, Leicester, UK
| | - Scott Sanders
- Department of Cellular Pathology, Warwick Hospital, Warwick, UK
| | - David MacDonald
- Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chris Haigh
- Department of Gastroenterology, Wansbeck General Hospital, Ashington, Northumberland, UK
| | - Art Tucker
- William Harvey Research Institute, The Ernest Cooke Vascular & Microvascular Unit, Centre for Clinical Pharmacology, St Bartholomew's Hospital, London, UK
| | - Sharon Love
- Centre for Statistics in Medicine and Oxford Clinical Trials Research Unit, Oxford, UK
| | - Manoj Nanji
- Centre for Digestive Diseases, Queen Mary University of London, London, UK
| | - John deCaestecker
- Department of Gastroenterology, Leicester General Hospital, Leicester, UK
| | - David Ferry
- Department of Oncology, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Barrie Rathbone
- Department for Gastroenterology, Leicester Royal Infirmary, Leicester, UK
| | - Julie Hapeshi
- Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK
| | - Hugh Barr
- Department of Upper GI Surgery, Gloucestershire, Royal Hospital, Gloucester, UK
| | - Paul Moayyedi
- Department of Medicine, McMaster HC, Hamilton Ontario, Canada
| | - Peter Watson
- School of Medicine, Dentistry, and Biomedical Sciences, Centre for Public Health, Queens University Belfast, NI
| | - Barbara Zietek
- Centre for Digestive Diseases, Queen Mary University of London, London, UK
| | - Neera Maroo
- Centre for Digestive Diseases, Queen Mary University of London, London, UK
| | - Laura Gay
- Centre for Digestive Diseases, Queen Mary University of London, London, UK
| | - Tim Underwood
- University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - Lisa Boulter
- University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - Hugh McMurtry
- Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Lancashire, UK
| | - David Monk
- General Surgery, Countess of Chester Hospital, Chester, UK
| | - Praful Patel
- Southampton University Hospitals NHS Trust, Southampton, UK
| | - Krish Ragunath
- Wolfson Digestive Diseases Centre, Queens Medical Centre, Nottingham, UK
| | - David Al Dulaimi
- Worcestershire Acute Hospitals NHS Trust, Alexandra Hospital, Redditch, UK
| | - Iain Murray
- Department of Gastroenterology, Royal Cornwall Hospital, Truro, Cornwall, UK
| | - Konrad Koss
- Macclesfield General Hospital, Macclefield, Cheshire, UK
| | - Andrew Veitch
- Department of Oncology, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Nigel Trudgill
- Department of Gastroenterology, Sandwell General Hospital, Lyndon, West Bromwich, UK
| | - Chuka Nwokolo
- Department of Gastroenterology, University Hospital of Coventry, Coventry, UK
| | - Bjorn Rembacken
- Department of Gastroenterology, Leeds General Infirmary, Leeds, UK
| | - Paul Atherfold
- Department of Clinical Pharmacology University of Oxford, Oxford, UK
| | - Elaine Green
- School of Biomedical & Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Yeng Ang
- Gastroenterology, Royal Albert Edward Infirmary NHS Trust, Wigan, UK; GI Science Centre, Salford Royal NHS Foundation Trust, University of Manchester, Salford, UK
| | - Ernst J Kuipers
- Department of Gastroenterology and Hepatology, Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Wu Chow
- Forth Valley Royal Hospital, Larbert, Scotland, UK
| | - Stuart Paterson
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norfolk and Norwich University Hospital, Norwich, UK
| | - Sudarshan Kadri
- Department for Gastroenterology, Leicester Royal Infirmary, Leicester, UK
| | - Ian Beales
- Burnley General Hospital, Burnley, Lancashire, UK
| | - Charles Grimley
- Head of Gastroenterology, University Hospital of Northern BC, Prince George, British Columbia, Canada
| | - Paul Mullins
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
| | - Conrad Beckett
- Royal United Hospital Bath NHS Trust, Royal United Hospital, Avon, Bath, Somerset, UK
| | - Mark Farrant
- Kettering General Hospital NHS Foundation Trust, Kettering General Hospital, Rothwell Road, Kettering, Northants, UK
| | - Andrew Dixon
- York Teaching Hospital NHS Foundation Trust, York, UK
| | - Sean Kelly
- Luton and Dunstable University Hospital NHS Foundation Trust, Luton, Bedfordshire, UK
| | - Matthew Johnson
- Department of Thoracic and Upper Gastrointestinal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Shahjehan Wajed
- County and Durham and Darlington NHS Foundation Trust, Bishop Auckland, County Durham, UK
| | - Anjan Dhar
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Elinor Sawyer
- Barts Cancer Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
| | - Rebecca Roylance
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Centre, Seattle, Washington
| | - Lynn Onstad
- Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina
| | - Marilie D Gammon
- Division of Research and San Francisco Medical Center, Kaiser Permanente Northern California, California
| | - Douglas A Corley
- Division of Gastroenterology and Hepatology, UNC School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | | | - Nigel C Bird
- Division of Epidemiology, University of Leeds, Leeds, UK
| | - Laura J Hardie
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Brian J Reid
- Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Weimin Ye
- Princess Margaret Cancer Centre, Ontario Cancer Institute, Toronto, ON, Canada
| | - Geoffrey Liu
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Yvonne Romero
- Registry, On behalf of the Romero; Department of Population Sciences, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, California
| | - Leslie Bernstein
- Department of Preventive Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, California
| | - Anna H Wu
- Department of Surgery, University of Saskatchewan, Saskatoon, Canada
| | - Alan G Casson
- MRC Cancer Cell Unit, Hutchison-MRC Research Centre and University of Cambridge, Cambridge, UK
| | - Rebecca Fitzgerald
- Cancer Control, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - David C Whiteman
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Harvey A Risch
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - David M Levine
- Department of Gastroenterology, Tergooi Hospital, Hilversum, The Netherlands
| | - Tom L Vaughan
- Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina
| | - Auke P Verhaar
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jan van den Brande
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Eelke L Toxopeus
- Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Manon C Spaander
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Bas P L Wijnhoven
- Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Luc J W van der Laan
- Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Kausilia Krishnadath
- Department of Genetics, University Medical Centre Groningen and University of Groningen, The Netherlands
| | - Cisca Wijmenga
- Department of Clinical Medicine & Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, St James's Hospital, Dublin, Ireland
| | - Gosia Trynka
- Department of Clinical Medicine & Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, St James's Hospital, Dublin, Ireland
| | - Ross McManus
- Department of Surgery, Trinity Centre for Health Sciences, Trinity College Dublin, St. James' Hospital, Dublin, Ireland
| | - John V Reynolds
- Gastrointestinal Unit, Mater Misericordiae University Hospital, University College Dublin, Dublin, Ireland
| | - Jacintha O'Sullivan
- Gastrointestinal Unit, Mater Misericordiae University Hospital, University College Dublin, Dublin, Ireland
| | - Padraic MacMathuna
- Faculty of Medicine, Imperial College London, South Kensington Campus, London, UK
| | - Sarah A McGarrigle
- Gastrointestinal Unit, Mater Misericordiae University Hospital, University College Dublin, Dublin, Ireland
| | - Dermot Kelleher
- Faculty of Medicine, Imperial College, South Kensington Campus, London, UK
| | - Severine Vermeire
- Department of Digestive Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Isabelle Cleynen
- Department of Digestive Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Raf Bisschops
- Department of Digestive Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Ian Tomlinson
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
| | - Janusz Jankowski
- University Hospitals Coventry & Warwickshire NHS Trust, Warwickshire, England; Warwick Medical School, University of Warwick, Warwickshire, England.
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