1
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Ding Y. Machine Learning Model Construction and Testing: Anticipating Cancer Incidence and Mortality. Diseases 2024; 12:139. [PMID: 39057110 PMCID: PMC11275333 DOI: 10.3390/diseases12070139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 06/24/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024] Open
Abstract
In recent years, the escalating environmental challenges have contributed to a rising incidence of cancer. The precise anticipation of cancer incidence and mortality rates has emerged as a pivotal focus in scientific inquiry, exerting a profound impact on the formulation of public health policies. This investigation adopts a pioneering machine learning framework to address this critical issue, utilizing a dataset encompassing 72,591 comprehensive records that include essential variables such as age, case count, population size, race, gender, site, and year of diagnosis. Diverse machine learning algorithms, including decision trees, random forests, logistic regression, support vector machines, and neural networks, were employed in this study. The ensuing analysis revealed testing accuracies of 62.17%, 61.92%, 54.53%, 55.72%, and 62.30% for the respective models. This state-of-the-art model not only enhances our understanding of cancer dynamics but also equips researchers and policymakers with the capability of making meticulous projections concerning forthcoming cancer incidence and mortality rates. Considering sustainability, the application of this advanced machine learning framework emphasizes the importance of judiciously utilizing extensive and intricate databases. By doing so, it facilitates a more sustainable approach to healthcare planning, allowing for informed decision-making that takes into account the long-term ecological and societal impacts of cancer-related policies. This integrative perspective underscores the broader commitment to sustainable practices in both health research and public policy formulation.
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Affiliation(s)
- Yuanzhao Ding
- School of Geography and the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY, UK
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2
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Familial history and prevalence of BRCA1, BRCA2 and TP53 pathogenic variants in HBOC Brazilian patients from a public healthcare service. Sci Rep 2022; 12:18629. [PMID: 36329109 PMCID: PMC9633799 DOI: 10.1038/s41598-022-23012-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Several studies have demonstrated the cost-effectiveness of genetic testing for surveillance and treatment of carriers of germline pathogenic variants associated with hereditary breast/ovarian cancer syndrome (HBOC). In Brazil, seventy percent of the population is assisted by the public Unified Health System (SUS), where genetic testing is still unavailable. And few studies were performed regarding the prevalence of HBOC pathogenic variants in this context. Here, we estimated the prevalence of germline pathogenic variants in BRCA1, BRCA2 and TP53 genes in Brazilian patients suspected of HBOC and referred to public healthcare service. Predictive power of risk prediction models for detecting mutation carriers was also evaluated. We found that 41 out of 257 tested patients (15.9%) were carriers of pathogenic variants in the analyzed genes. Most frequent pathogenic variant was the founder Brazilian mutation TP53 c.1010G > A (p.Arg337His), adding to the accumulated evidence that supports inclusion of TP53 in routine testing of Brazilian HBOC patients. Surprisingly, BRCA1 c.5266dupC (p.Gln1756fs), a frequently reported pathogenic variant in Brazilian HBOC patients, was not observed. Regarding the use of predictive models, we found that familial history of cancer might be used to improve selection or prioritization of patients for genetic testing, especially in a context of limited resources.
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3
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Park MS, Weissman SM, Postula KJV, Williams CS, Mauer CB, O'Neill SM. Utilization of breast cancer risk prediction models by cancer genetic counselors in clinical practice predominantly in the United States. J Genet Couns 2021; 30:1737-1747. [PMID: 34076301 DOI: 10.1002/jgc4.1442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 01/07/2023]
Abstract
Risk assessment in cancer genetic counseling is essential in identifying individuals at high risk for developing breast cancer to recommend appropriate screening and management options. Historically, many breast cancer risk prediction models were developed to calculate an individual's risk to develop breast cancer or to carry a pathogenic variant in the BRCA1 or BRCA2 genes. However, how or when genetic counselors use these models in clinical settings is currently unknown. We explored genetic counselors' breast cancer risk model usage patterns including frequency of use, reasons for using or not using models, and change in usage since the adoption of multi-gene panel testing. An online survey was developed and sent to members of the National Society of Genetic Counselors; board-certified genetic counselors whose practice included cancer genetic counseling were eligible to participate in the study. The response rate was estimated at 23% (243/1,058), and respondents were predominantly working in the United States. The results showed that 93% of all respondents use at least one breast cancer risk prediction model in their clinical practice. Among the six risk models selected for the study, the Tyrer-Cuzick (IBIS) model was used most frequently (95%), and the BOADICEA model was used least (40%). Determining increased or decreased surveillance and breast MRI eligibility were the two most common reasons for most model usage, while time consumption and difficulty in navigation were the two most common reasons for not using models. This study provides insight into perceived benefits and limitations of risk models in clinical use in the United States, which may be useful information for software developers, genetic counseling program curriculum developers, and currently practicing cancer genetic counselors.
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Affiliation(s)
- Min Seon Park
- Northwestern Medical Group, Chicago, IL, USA.,Northwestern University Feinberg School of Medicine Graduate Program in Genetic Counseling, Chicago, IL, USA
| | | | | | - Carmen S Williams
- Northwestern Medical Group, Chicago, IL, USA.,Northwestern University Feinberg School of Medicine Graduate Program in Genetic Counseling, Chicago, IL, USA
| | | | - Suzanne M O'Neill
- Northwestern University Feinberg School of Medicine Graduate Program in Genetic Counseling, Chicago, IL, USA
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4
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Louro J, Román M, Posso M, Comerma L, Vidal C, Saladié F, Alcantara R, Sanchez M, Quintana MJ, Del Riego J, Ferrer J, Peñalva L, Bargalló X, Prieto M, Sala M, Castells X. Differences in breast cancer risk after benign breast disease by type of screening diagnosis. Breast 2020; 54:343-348. [PMID: 33023825 PMCID: PMC7770442 DOI: 10.1016/j.breast.2020.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/24/2020] [Accepted: 09/04/2020] [Indexed: 02/01/2023] Open
Abstract
Introduction We aimed to assess differences in breast cancer risk across benign breast disease diagnosed at prevalent or incident screens. Materials and methods We conducted a retrospective cohort study with data from 629,087 women participating in a long-standing population-based breast cancer screening program in Spain. Each benign breast disease was classified as non-proliferative, proliferative without atypia, or proliferative with atypia, and whether it was diagnosed in a prevalent or incident screen. We used partly conditional Cox hazard regression to estimate the adjusted hazard ratios of the risk of breast cancer. Results Compared with women without benign breast disease, the risk of breast cancer was significantly higher (p-value = 0.005) in women with benign breast disease diagnosed in an incident screen (aHR, 2.67; 95%CI: 2.24–3.19) than in those with benign breast disease diagnosed in a prevalent screen (aHR, 1.87; 95%CI: 1.57–2.24). The highest risk was found in women with a proliferative benign breast disease with atypia (aHR, 4.35; 95%CI: 2.09–9.08, and 3.35; 95%CI: 1.51–7.40 for those diagnosed at incident and prevalent screens, respectively), while the lowest was found in women with non-proliferative benign breast disease (aHR, 2.39; 95%CI: 1.95–2.93, and 1.63; 95%CI: 1.32–2.02 for those diagnosed at incident and prevalent screens, respectively). Conclusion Our study showed that the risk of breast cancer conferred by a benign breast disease differed according to type of screen (prevalent or incident). To our knowledge, this is the first study to analyse the impact of the screening type on benign breast disease prognosis. Breast cancer risk after a benign breast disease varied with the screening type. Incident benign breast disease had a higher breast cancer risk than prevalent. The risk remained increased regardless of benign breast disease subtype.
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Affiliation(s)
- Javier Louro
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain; Servei D'Epidemiologia I Avaluació, Hospital Del Mar, Barcelona, Spain; European Higher Education Area (EHEA) Doctoral Programme in Methodology of Biomedical Research and Public Health in Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autónoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
| | - Marta Román
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain; Servei D'Epidemiologia I Avaluació, Hospital Del Mar, Barcelona, Spain
| | - Margarita Posso
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain; Servei D'Epidemiologia I Avaluació, Hospital Del Mar, Barcelona, Spain
| | - Laura Comerma
- Servei de Patologia, Hospital Del Mar, Barcelona, Spain
| | - Carmen Vidal
- Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Francina Saladié
- Cancer Epidemiology and Prevention Service, Hospital Universitari Sant Joan de Reus, Institut D'Investigació Sanitària Pere Virgili, Universitat Rovira I Virgili, Reus, Spain
| | - Rodrigo Alcantara
- Servei de Diagnòstic per La Imatge, Hospital Del Mar, Barcelona, Spain
| | - Mar Sanchez
- Direction General of Public Health, Cantabria, Spain
| | - M Jesús Quintana
- Department of Clinical Epidemiology and Public Health, University Hospital de La Santa Creu I Sant Pau, IIB Sant Pau, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain
| | - Javier Del Riego
- Women's Imaging, Department of Radiology, UDIAT Centre Diagnòstic, Parc Taulí Hospital Universitari, Sabadell, Barcelona, Spain
| | - Joana Ferrer
- Radiology Department, Hospital de Santa Caterina, Salt, Girona, Spain
| | - Lupe Peñalva
- Vallés Oriental Breast Cancer Early Detection Program, Spain
| | | | - Miguel Prieto
- Breast Cancer Screening Program, Principality of Asturias, Spain
| | - María Sala
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain; Servei D'Epidemiologia I Avaluació, Hospital Del Mar, Barcelona, Spain
| | - Xavier Castells
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain; Servei D'Epidemiologia I Avaluació, Hospital Del Mar, Barcelona, Spain.
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5
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Vianna FSL, Giacomazzi J, Oliveira Netto CB, Nunes LN, Caleffi M, Ashton-Prolla P, Camey SA. Performance of the Gail and Tyrer-Cuzick breast cancer risk assessment models in women screened in a primary care setting with the FHS-7 questionnaire. Genet Mol Biol 2019; 42:232-237. [PMID: 31170278 PMCID: PMC6687344 DOI: 10.1590/1678-4685-gmb-2018-0110] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/12/2018] [Indexed: 12/21/2022] Open
Abstract
Breast cancer (BC) risk assessment models base their estimations on different aspects of a woman's personal and familial history. The Gail and Tyrer-Cuzick models are the most commonly used, and BC risks assigned by them vary considerably especially concerning familial history. In this study, our aim was to compare the Gail and Tyrer-Cuzick models after initial screening for familial history of cancer in primary care using the FHS-7 questionnaire. We compared 846 unrelated women with at least one positive answer to any of the seven FHS-7 questions (positive group) and 892 unrelated women that answered negatively (negative group). Concordance between BC risk estimates was compared by Bland-Altman graphics. Mean BC risk estimates were higher using the Tyrer-Cuzick Model in women from the positive group, while women from the negative group had higher BC risk estimates using the Gail model. With increasing estimates, discordance also increased, mainly in the FHS-7 positive group. Our results show that in women with a familial history of cancer, the Gail model underestimates risk and the Tyrer-Cuzick seems to be more appropriate. FHS-7 can be a useful tool for the identification of women with higher breast cancer risks in the primary care setting.
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Affiliation(s)
- Fernanda Sales Luiz Vianna
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Laboratório de Medicina Genômica, Centro de Pesquisa Experimental do Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | - Luciana Neves Nunes
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Maira Caleffi
- Associação Hospitalar Moinhos de Vento, Porto Alegre, RS, Brazil
| | - Patricia Ashton-Prolla
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Laboratório de Medicina Genômica, Centro de Pesquisa Experimental do Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Suzi Alves Camey
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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6
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Gabrielson M, Eriksson M, Hammarström M, Borgquist S, Leifland K, Czene K, Hall P. Cohort Profile: The Karolinska Mammography Project for Risk Prediction of Breast Cancer (KARMA). Int J Epidemiol 2018; 46:1740-1741g. [PMID: 28180256 PMCID: PMC5837703 DOI: 10.1093/ije/dyw357] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2016] [Indexed: 12/24/2022] Open
Affiliation(s)
- Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mattias Hammarström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Signe Borgquist
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Karin Leifland
- Department of Medical Imaging, Stockholm South General Hospital, Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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7
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Zhang W, Zhang Z. Associations between XRCC2 rs3218536 and ERCC2 rs13181 polymorphisms and ovarian cancer. Oncotarget 2016; 7:86621-86629. [PMID: 27863412 PMCID: PMC5349940 DOI: 10.18632/oncotarget.13361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 10/29/2016] [Indexed: 01/11/2023] Open
Abstract
Recent studies explored XRCC2 rs3218536 and ERCC2 rs13181 polymorphisms and ovarian cancer (OC) risk. However, the association between these two single nucleotide polymorphisms and OC risk remains conflicting. Thus, we conducted a comprehensive systematic review and meta-analysis to investigate the association. We searched the databases of PubMed, and Embase. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by using fixed-effect or random-effect models. 15 case-control studies published in 11 papers including 4,757 cases and 8,431 controls were included in this meta-analysis. No associations were obtained between XRCC2 rs3218536 and ERCC2 rs13181 polymorphisms and OC risk. Stratification analyses of Hardy–Weinberg equilibrium status indicated that rs3218536 polymorphism was associated with the decreased risk of OC when in analysis of combined HWE positive studies. In conclusion, this meta-analysis indicates that XRCC2 rs3218536 and ERCC2 rs13181 polymorphisms may not be associated with the risk of OC.
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Affiliation(s)
- Wei Zhang
- Department of Gynecology, Nanjing Medical University, Affiliated Hangzhou Hospital, Hangzhou First People's Hospital, 310006, Hangzhou, China
| | - Zhifen Zhang
- Department of Gynecology, Nanjing Medical University, Affiliated Hangzhou Hospital, Hangzhou First People's Hospital, 310006, Hangzhou, China
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8
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Rashid MU, Muhammad N, Bajwa S, Faisal S, Tahseen M, Bermejo JL, Amin A, Loya A, Hamann U. High prevalence and predominance of BRCA1 germline mutations in Pakistani triple-negative breast cancer patients. BMC Cancer 2016; 16:673. [PMID: 27553291 PMCID: PMC4995655 DOI: 10.1186/s12885-016-2698-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 08/09/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Women harboring BRCA1/2 germline mutations have high lifetime risk of developing breast/ovarian cancer. The recommendation to pursue BRCA1/2 testing is based on patient's family history of breast/ovarian cancer, age of disease-onset and/or pathologic parameters of breast tumors. Here, we investigated if diagnosis of triple-negative breast cancer (TNBC) independently increases risk of carrying a BRCA1/2 mutation in Pakistan. METHODS Five hundred and twenty-three breast cancer patients including 237 diagnosed ≤ 30 years of age and 286 with a family history of breast/ovarian cancer were screened for BRCA1/2 small-range mutations and large genomic rearrangements. Immunohistochemical analyses were performed at one center. Univariate and multiple logistic regression models were used to investigate possible differences in prevalence of BRCA1/2 mutations according to patient and tumor characteristics. RESULTS Thirty-seven percent of patients presented with TNBC. The prevalence of BRCA1 mutations was higher in patients with TNBC than non-TNBC (37 % vs. 10 %, P < 0.0001). 1 % of TNBC patients were observed to have BRCA2 mutations. Subgroup analyses revealed a larger proportion of BRCA1 mutations in TNBC than non-TNBC among patients 1) diagnosed at early-age with no family history of breast/ovarian cancer (14 % vs. 5 %, P = 0.03), 2) diagnosed at early-age irrespective of family history (28 % vs. 11 %, P = 0.0003), 3) had a family history of breast cancer (49 % vs. 12 %, P < 0.0001), and 4) those with family history of breast and ovarian cancer (81 % vs. 28 %, P = 0.0005). TNBC patients harboring BRCA1 mutations were diagnosed at a later age than non-carriers (median age at diagnosis: 30 years (range 22-53) vs. 28 years (range 18-67), P = 0.002). The association between TNBC status and presence of BRCA1 mutations was independent of the simultaneous consideration of family phenotype, tumor histology and grade in a multiple logistic regression model (Ratio of the probability of carrying BRCA1/2 mutations for TNBC vs. non-TNBC 4.23; 95 % CI 2.50-7.14; P < 0.0001). CONCLUSION Genetic BRCA1 testing should be considered for Pakistani women diagnosed with TNBC.
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Affiliation(s)
- Muhammad Usman Rashid
- Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan.,German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany
| | - Noor Muhammad
- Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
| | - Seerat Bajwa
- Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
| | - Saima Faisal
- Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
| | - Muhammad Tahseen
- Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
| | - Justo Lorenzo Bermejo
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Asim Amin
- Levine Cancer Institute (LCI), Charlotte, USA
| | - Asif Loya
- Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
| | - Ute Hamann
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg, Germany.
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9
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Permuth JB, Pirie A, Ann Chen Y, Lin HY, Reid BM, Chen Z, Monteiro A, Dennis J, Mendoza-Fandino G, Anton-Culver H, Bandera EV, Bisogna M, Brinton L, Brooks-Wilson A, Carney ME, Chenevix-Trench G, Cook LS, Cramer DW, Cunningham JM, Cybulski C, D'Aloisio AA, Anne Doherty J, Earp M, Edwards RP, Fridley BL, Gayther SA, Gentry-Maharaj A, Goodman MT, Gronwald J, Hogdall E, Iversen ES, Jakubowska A, Jensen A, Karlan BY, Kelemen LE, Kjaer SK, Kraft P, Le ND, Levine DA, Lissowska J, Lubinski J, Matsuo K, Menon U, Modugno R, Moysich KB, Nakanishi T, Ness RB, Olson S, Orlow I, Pearce CL, Pejovic T, Poole EM, Ramus SJ, Anne Rossing M, Sandler DP, Shu XO, Song H, Taylor JA, Teo SH, Terry KL, Thompson PJ, Tworoger SS, Webb PM, Wentzensen N, Wilkens LR, Winham S, Woo YL, Wu AH, Yang H, Zheng W, Ziogas A, Phelan CM, Schildkraut JM, Berchuck A, Goode EL, Pharoah PDP, Sellers TA. Exome genotyping arrays to identify rare and low frequency variants associated with epithelial ovarian cancer risk. Hum Mol Genet 2016; 25:3600-3612. [PMID: 27378695 PMCID: PMC5179948 DOI: 10.1093/hmg/ddw196] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 06/17/2016] [Accepted: 06/20/2016] [Indexed: 12/17/2022] Open
Abstract
Rare and low frequency variants are not well covered in most germline genotyping arrays and are understudied in relation to epithelial ovarian cancer (EOC) risk. To address this gap, we used genotyping arrays targeting rarer protein-coding variation in 8,165 EOC cases and 11,619 controls from the international Ovarian Cancer Association Consortium (OCAC). Pooled association analyses were conducted at the variant and gene level for 98,543 variants directly genotyped through two exome genotyping projects. Only common variants that represent or are in strong linkage disequilibrium (LD) with previously-identified signals at established loci reached traditional thresholds for exome-wide significance (P < 5.0 × 10 - 7). One of the most significant signals (Pall histologies = 1.01 × 10 - 13;Pserous = 3.54 × 10 - 14) occurred at 3q25.31 for rs62273959, a missense variant mapping to the LEKR1 gene that is in LD (r2 = 0.90) with a previously identified 'best hit' (rs7651446) mapping to an intron of TIPARP. Suggestive associations (5.0 × 10 - 5 > P≥5.0 ×10 - 7) were detected for rare and low-frequency variants at 16 novel loci. Four rare missense variants were identified (ACTBL2 rs73757391 (5q11.2), BTD rs200337373 (3p25.1), KRT13 rs150321809 (17q21.2) and MC2R rs104894658 (18p11.21)), but only MC2R rs104894668 had a large effect size (OR = 9.66). Genes most strongly associated with EOC risk included ACTBL2 (PAML = 3.23 × 10 - 5; PSKAT-o = 9.23 × 10 - 4) and KRT13 (PAML = 1.67 × 10 - 4; PSKAT-o = 1.07 × 10 - 5), reaffirming variant-level analysis. In summary, this large study identified several rare and low-frequency variants and genes that may contribute to EOC susceptibility, albeit with possible small effects. Future studies that integrate epidemiology, sequencing, and functional assays are needed to further unravel the unexplained heritability and biology of this disease.
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Affiliation(s)
- Jennifer B Permuth
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Ailith Pirie
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Y Ann Chen
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Hui-Yi Lin
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Brett M Reid
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Zhihua Chen
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Alvaro Monteiro
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Joe Dennis
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | | | - Hoda Anton-Culver
- Department of Epidemiology, Director of Genetic Epidemiology Research Institute, UCI School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Elisa V Bandera
- Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Maria Bisogna
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Louise Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Angela Brooks-Wilson
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver BC, Canada
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Michael E Carney
- Department of Obstetrics and Gynecology, John A Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | - Georgia Chenevix-Trench
- Genetics and Computational Biology Department, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - Linda S Cook
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Daniel W Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Julie M Cunningham
- Department of Laboratory of Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | | | - Jennifer Anne Doherty
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NY, USA
| | - Madalene Earp
- Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Robert P Edwards
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Ovarian Cancer Center of Excellence, Womens Cancer Research Program, Magee- Womens Research Institute & University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Brooke L Fridley
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Simon A Gayther
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | | | - Marc T Goodman
- Cancer Prevention and Control, Samuel Oshin Comprehensive Cancer Institute, Cedars- Sinai Medical Center, Los Angeles, CA, USA
- Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Estrid Hogdall
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark and Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Edwin S Iversen
- Department of Statistical Science, Duke University, Durham, NC, USA
| | - Anna Jakubowska
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Allan Jensen
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Beth Y Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina College of Medicine, Charleston, SC, USA
| | - Suzanne K Kjaer
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Nhu D Le
- Cancer Control Research, BC Cancer Agency, Vancouver, BC, Canada
| | - Douglas A Levine
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, The Maria Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland
| | - Jan Lubinski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Usha Menon
- Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Rosemary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Ovarian Cancer Center of Excellence, Womens Cancer Research Program, Magee- Womens Research Institute & University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Toru Nakanishi
- Department of Gynecologic Oncology, Aichi Cancer Center Central Hospital, Nagoya, Aichi, Japan
| | - Roberta B Ness
- The University of Texas School of Public Health, Houston, TX, USA
| | - Sara Olson
- Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York,NY, USA
| | - Irene Orlow
- Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York,NY, USA
| | - Celeste L Pearce
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
- Department of Epidemology,University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Tanja Pejovic
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Susan J Ramus
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Dale P Sandler
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Xiao-Ou Shu
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Honglin Song
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jack A Taylor
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Soo-Hwang Teo
- Cancer Research Malaysia, Subang Jaya, Malaysia
- University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia
| | - Kathryn L Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Pamela J Thompson
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda MD, USA
| | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Hawaii, USA
| | - Stacey Winham
- Department of Health Science Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Yin-Ling Woo
- Department of Obstetrics and Gynaecology, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia
| | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Hannah Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda MD, USA
| | - Wei Zheng
- Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Argyrios Ziogas
- Department of Epidemiology, University of California Irvine, Irvine, CA, USA
| | - Catherine M Phelan
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Joellen M Schildkraut
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, USA
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA, Exome genotyping arrays to identify rare and low frequency variants associated with epithelial ovarian cancer risk
| | - Ellen L Goode
- Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Paul D P Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Thomas A Sellers
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
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10
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Azzollini J, Scuvera G, Bruno E, Pasanisi P, Zaffaroni D, Calvello M, Pasini B, Ripamonti CB, Colombo M, Pensotti V, Radice P, Peissel B, Manoukian S. Mutation detection rates associated with specific selection criteria for BRCA1/2 testing in 1854 high-risk families: A monocentric Italian study. Eur J Intern Med 2016; 32:65-71. [PMID: 27062684 DOI: 10.1016/j.ejim.2016.03.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/09/2016] [Accepted: 03/11/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND BRCA mutation screening is frequently offered on the basis of the fulfillment of empirical selection criteria, thought to be indicative of a genetic predisposition to breast/ovarian cancer (BrCa/OvCa). This study aimed to evaluate, in a large cohort of BrCa/OvCa families, the mutation detection rate (DR) associated with specific clinical features and the relative performance of the employed selection criteria. METHODS BRCA gene analysis was performed on 1854 family probands. The Fisher exact test was used to compare the DRs associated with different clinical features. In a subset of families fulfilling only mutually exclusive criteria, odds ratios and 95% CI were estimated to test the relative effectiveness of each criterion. RESULTS The overall DR was 29.3%. Among BrCa-only families, the DRs were significantly higher in the presence of early-onset compared with late-onset cases, and of bilateral compared with unilateral cases. In families with bilateral cases, ages at diagnosis of both the first and second tumour were significantly lower in mutation carriers. In families fulfilling mutually exclusive criteria, OvCa was the best predictor of BRCA mutations, with DRs (range: 31.8%-80.0%) significantly higher compared with the other criteria. Conversely, isolated early-onset BrCa and three or more late-onset BrCa displayed significantly lower predictive values (7.9% and 7.2%, respectively). CONCLUSIONS The observed estimates, albeit confirming a DR above 10% for most of the considered criteria, highlighted some relevant differences among them. Such differences should be taken into account in the identification of patients who might benefit from genetic counselling and subsequent testing.
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Affiliation(s)
- Jacopo Azzollini
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Giulietta Scuvera
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Eleonora Bruno
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Italy.
| | - Patrizia Pasanisi
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Daniela Zaffaroni
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Mariarosaria Calvello
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Italy; Department of Predictive Medicine and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Carla B Ripamonti
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Mara Colombo
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Valeria Pensotti
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy; Cogentech Cancer Genetics Test Laboratory, Milan, Italy.
| | - Paolo Radice
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Bernard Peissel
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Siranoush Manoukian
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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11
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Riahi A, Ghourabi ME, Fourati A, Chaabouni-Bouhamed H. Family history predictors of BRCA1/BRCA2 mutation status among Tunisian breast/ovarian cancer families. Breast Cancer 2016; 24:238-244. [PMID: 27025497 DOI: 10.1007/s12282-016-0693-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/17/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND With the increasing request for BRCA1/BRCA2 mutation tests, several risk models have been developed to predict the presence of mutation in these genes; in this study, we have developed an efficient BRCA genetic testing strategy. METHOD As first step, to identify predictor variables associated with BRCA status, we have undertaken a cumulative mutation analysis including data from three Tunisian studies. Then, we have developed a logistic regression model for predicting the likelihood of harboring a BRCA mutation. Using receiver operating characteristic curves (ROC), an effective evaluation was performed. A total of 92 Tunisian families were included. Overall, 27 women were positive for BRCA1/BRCA2 deleterious mutations. RESULTS Tow recurrent mutations (c.211dupA and c.5266dupC) explained 76 % of BRCA1-related families and three recurrent mutations (c.1310_1313del, c.1542_1547delAAGA and c.7887_7888insA) explained 90 % of BRCA2-related families. Early age at diagnosis of breast cancer, ovarian cancer, bilateral breast cancer were associated with BRCA1, whereas male breast cancer and four or more breast cancer cases in the family were associated with BRCA2. The area under the receiver operating characteristic curve of the risk score was 0.802 (95 % confidence interval = 0.0699-0. 905). CONCLUSION Logistic regression reported particular profiles related to BRCA germline mutation carriers in our population, as well as an efficient prediction model that may be a useful tool for increasing the cost-effectiveness of genetic testing strategy.
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Affiliation(s)
- Aouatef Riahi
- Laboratoire Génétique Humaine, Faculté de Médecine de Tunis, University Tunis El Manar, 3, Rue ALI DOUAGI, Bardo, Tunis, Tunisia.
| | - Mohamel El Ghourabi
- High School of Economic and Commercial Sciences of Tunis, University of Tunis, Tunis, Tunisia
| | - Asma Fourati
- Department of Immunohistocytology, Salah Azaiz Institute, Tunis, Tunisia
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12
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Kurian AW, Antoniou AC, Domchek SM. Refining Breast Cancer Risk Stratification: Additional Genes, Additional Information. Am Soc Clin Oncol Educ Book 2016; 35:44-56. [PMID: 27249685 DOI: 10.1200/edbk_158817] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Recent advances in genomic technology have enabled far more rapid, less expensive sequencing of multiple genes than was possible only a few years ago. Advances in bioinformatics also facilitate the interpretation of large amounts of genomic data. New strategies for cancer genetic risk assessment include multiplex sequencing panels of 5 to more than 100 genes (in which rare mutations are often associated with at least two times the average risk of developing breast cancer) and panels of common single-nucleotide polymorphisms (SNPs), combinations of which are generally associated with more modest cancer risks (more than twofold). Although these new multiple-gene panel tests are used in oncology practice, questions remain about the clinical validity and the clinical utility of their results. To translate this increasingly complex genetic information for clinical use, cancer risk prediction tools are under development that consider the joint effects of all susceptibility genes, together with other established breast cancer risk factors. Risk-adapted screening and prevention protocols are underway, with ongoing refinement as genetic knowledge grows. Priority areas for future research include the clinical validity and clinical utility of emerging genetic tests; the accuracy of developing cancer risk prediction models; and the long-term outcomes of risk-adapted screening and prevention protocols, in terms of patients' experiences and survival.
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Affiliation(s)
- Allison W Kurian
- From the Departments of Medicine and of Health Research and Policy, Stanford University School of Medicine, Stanford, CA; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Basser Research Center and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Antonis C Antoniou
- From the Departments of Medicine and of Health Research and Policy, Stanford University School of Medicine, Stanford, CA; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Basser Research Center and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Susan M Domchek
- From the Departments of Medicine and of Health Research and Policy, Stanford University School of Medicine, Stanford, CA; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Basser Research Center and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
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13
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Kar SP, Tyrer JP, Li Q, Lawrenson K, Aben KKH, Anton-Culver H, Antonenkova N, Chenevix-Trench G, Baker H, Bandera EV, Bean YT, Beckmann MW, Berchuck A, Bisogna M, Bjørge L, Bogdanova N, Brinton L, Brooks-Wilson A, Butzow R, Campbell I, Carty K, Chang-Claude J, Chen YA, Chen Z, Cook LS, Cramer D, Cunningham JM, Cybulski C, Dansonka-Mieszkowska A, Dennis J, Dicks E, Doherty JA, Dörk T, du Bois A, Dürst M, Eccles D, Easton DF, Edwards RP, Ekici AB, Fasching PA, Fridley BL, Gao YT, Gentry-Maharaj A, Giles GG, Glasspool R, Goode EL, Goodman MT, Grownwald J, Harrington P, Harter P, Hein A, Heitz F, Hildebrandt MAT, Hillemanns P, Hogdall E, Hogdall CK, Hosono S, Iversen ES, Jakubowska A, Paul J, Jensen A, Ji BT, Karlan BY, Kjaer SK, Kelemen LE, Kellar M, Kelley J, Kiemeney LA, Krakstad C, Kupryjanczyk J, Lambrechts D, Lambrechts S, Le ND, Lee AW, Lele S, Leminen A, Lester J, Levine DA, Liang D, Lissowska J, Lu K, Lubinski J, Lundvall L, Massuger L, Matsuo K, McGuire V, McLaughlin JR, McNeish IA, Menon U, Modugno F, Moysich KB, Narod SA, Nedergaard L, Ness RB, Nevanlinna H, Odunsi K, Olson SH, Orlow I, Orsulic S, Weber RP, Pearce CL, Pejovic T, Pelttari LM, Permuth-Wey J, Phelan CM, Pike MC, Poole EM, Ramus SJ, Risch HA, Rosen B, Rossing MA, Rothstein JH, Rudolph A, Runnebaum IB, Rzepecka IK, Salvesen HB, Schildkraut JM, Schwaab I, Shu XO, Shvetsov YB, Siddiqui N, Sieh W, Song H, Southey MC, Sucheston-Campbell LE, Tangen IL, Teo SH, Terry KL, Thompson PJ, Timorek A, Tsai YY, Tworoger SS, van Altena AM, Van Nieuwenhuysen E, Vergote I, Vierkant RA, Wang-Gohrke S, Walsh C, Wentzensen N, Whittemore AS, Wicklund KG, Wilkens LR, Woo YL, Wu X, Wu A, Yang H, Zheng W, Ziogas A, Sellers TA, Monteiro ANA, Freedman ML, Gayther SA, Pharoah PDP. Network-Based Integration of GWAS and Gene Expression Identifies a HOX-Centric Network Associated with Serous Ovarian Cancer Risk. Cancer Epidemiol Biomarkers Prev 2015; 24:1574-84. [PMID: 26209509 PMCID: PMC4592449 DOI: 10.1158/1055-9965.epi-14-1270] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 06/29/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Genome-wide association studies (GWAS) have so far reported 12 loci associated with serous epithelial ovarian cancer (EOC) risk. We hypothesized that some of these loci function through nearby transcription factor (TF) genes and that putative target genes of these TFs as identified by coexpression may also be enriched for additional EOC risk associations. METHODS We selected TF genes within 1 Mb of the top signal at the 12 genome-wide significant risk loci. Mutual information, a form of correlation, was used to build networks of genes strongly coexpressed with each selected TF gene in the unified microarray dataset of 489 serous EOC tumors from The Cancer Genome Atlas. Genes represented in this dataset were subsequently ranked using a gene-level test based on results for germline SNPs from a serous EOC GWAS meta-analysis (2,196 cases/4,396 controls). RESULTS Gene set enrichment analysis identified six networks centered on TF genes (HOXB2, HOXB5, HOXB6, HOXB7 at 17q21.32 and HOXD1, HOXD3 at 2q31) that were significantly enriched for genes from the risk-associated end of the ranked list (P < 0.05 and FDR < 0.05). These results were replicated (P < 0.05) using an independent association study (7,035 cases/21,693 controls). Genes underlying enrichment in the six networks were pooled into a combined network. CONCLUSION We identified a HOX-centric network associated with serous EOC risk containing several genes with known or emerging roles in serous EOC development. IMPACT Network analysis integrating large, context-specific datasets has the potential to offer mechanistic insights into cancer susceptibility and prioritize genes for experimental characterization.
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Affiliation(s)
- Siddhartha P Kar
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
| | - Jonathan P Tyrer
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Qiyuan Li
- Department of Medical Oncology, The Center for Functional Cancer Epigenetics, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kate Lawrenson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Katja K H Aben
- Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, the Netherlands. Comprehensive Cancer Center The Netherlands, Utrecht, the Netherlands
| | - Hoda Anton-Culver
- Department of Epidemiology, Director of Genetic Epidemiology Research Institute, School of Medicine, University of California Irvine, Irvine, California
| | - Natalia Antonenkova
- Byelorussian Institute for Oncology and Medical Radiology Aleksandrov N.N., Minsk, Belarus
| | | | - Helen Baker
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Elisa V Bandera
- Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Yukie T Bean
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon. Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Matthias W Beckmann
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
| | - Maria Bisogna
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Line Bjørge
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway. Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Natalia Bogdanova
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Louise Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Angela Brooks-Wilson
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, British Columbia, Canada. Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Ralf Butzow
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, HUS, Finland. Department of Pathology, Helsinki University Central Hospital, Helsinki, Finland
| | - Ian Campbell
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. Department of Pathology, University of Melbourne, Parkville, Victoria, Australia. Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Karen Carty
- Cancer Research UK Clinical Trials Unit, The Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Jenny Chang-Claude
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Yian Ann Chen
- Department of Biostatistics, Moffitt Cancer Center, Tampa, Florida
| | - Zhihua Chen
- Department of Biostatistics, Moffitt Cancer Center, Tampa, Florida
| | - Linda S Cook
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Daniel Cramer
- Obstetrics and Gynecology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Harvard School of Public Health, Boston, Massachusetts
| | - Julie M Cunningham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Cezary Cybulski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Agnieszka Dansonka-Mieszkowska
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Ed Dicks
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Jennifer A Doherty
- Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Andreas du Bois
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany. Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | - Matthias Dürst
- Department of Gynecology, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Diana Eccles
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Robert P Edwards
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom. Ovarian Cancer Center of Excellence, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Arif B Ekici
- University Hospital Erlangen, Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Peter A Fasching
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany. University of California at Los Angeles, David Geffen School of Medicine, Department of Medicine, Division of Hematology and Oncology, Los Angeles, California
| | - Brooke L Fridley
- Biostatistics and Informatics Shared Resource, University of Kansas Medical Center, Kansas City, Kansas
| | | | - Aleksandra Gentry-Maharaj
- Women's Cancer, University College London Elizabeth Garrett Anderson Institute for Women's Health, London, United Kingdom
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Rosalind Glasspool
- Cancer Research UK Clinical Trials Unit, The Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Ellen L Goode
- Department of Health Science Research, Mayo Clinic, Rochester, Minnesota
| | - Marc T Goodman
- Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California. Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jacek Grownwald
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Patricia Harrington
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Philipp Harter
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany. Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | - Alexander Hein
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - Florian Heitz
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany. Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | | | - Peter Hillemanns
- Departments of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
| | - Estrid Hogdall
- Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark. Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Claus K Hogdall
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Satoyo Hosono
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Edwin S Iversen
- Department of Statistical Science, Duke University, Durham, North Carolina
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - James Paul
- Cancer Research UK Clinical Trials Unit, The Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Allan Jensen
- Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Bu-Tian Ji
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Beth Y Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Susanne K Kjaer
- Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark. Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Melissa Kellar
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon. Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Joseph Kelley
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Lambertus A Kiemeney
- Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Camilla Krakstad
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway. Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jolanta Kupryjanczyk
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Diether Lambrechts
- Vesalius Research Center, VIB, Leuven, Belgium. Laboratory for Translational Genetics, Department of Oncology, University of Leuven, Leuven, Belgium
| | - Sandrina Lambrechts
- Division of Gynecological Oncology, Department of Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Nhu D Le
- Cancer Control Research, BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Alice W Lee
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Shashi Lele
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Arto Leminen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, HUS, Finland
| | - Jenny Lester
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Douglas A Levine
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Dong Liang
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, Texas
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Karen Lu
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Lene Lundvall
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Leon Massuger
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Nijmegen, the Netherlands
| | - Keitaro Matsuo
- Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan
| | - Valerie McGuire
- Department of Health Research and Policy-Epidemiology, Stanford University School of Medicine, Stanford, California
| | - John R McLaughlin
- Prosserman Centre for Health Research, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Iain A McNeish
- Institute of Cancer Sciences, University of Glasgow, Wolfson Wohl Cancer Research Centre, Beatson Institute for Cancer Research, Glasgow, United Kingdom
| | - Usha Menon
- Women's Cancer, University College London Elizabeth Garrett Anderson Institute for Women's Health, London, United Kingdom
| | - Francesmary Modugno
- Ovarian Cancer Center of Excellence, University of Pittsburgh, Pittsburgh, Pennsylvania. Women's Cancer Research Program, Magee-Women's Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Steven A Narod
- Women's College Research Institute, Toronto, Ontario, Canada
| | - Lotte Nedergaard
- Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Roberta B Ness
- The University of Texas School of Public Health, Houston, Texas
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, HUS, Finland
| | - Kunle Odunsi
- Department of Gynecological Oncology, Roswell Park Cancer Institute, Buffalo, New York
| | - Sara H Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sandra Orsulic
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Rachel Palmieri Weber
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
| | - Celeste Leigh Pearce
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Tanja Pejovic
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon. Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Liisa M Pelttari
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, HUS, Finland
| | | | - Catherine M Phelan
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Malcolm C Pike
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Susan J Ramus
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Harvey A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Barry Rosen
- Department of Gynecologic-Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. Department of Epidemiology, University of Washington, Seattle, Washington
| | - Joseph H Rothstein
- Department of Health Research and Policy-Epidemiology, Stanford University School of Medicine, Stanford, California
| | - Anja Rudolph
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Ingo B Runnebaum
- Department of Gynecology, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Iwona K Rzepecka
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Helga B Salvesen
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway. Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Joellen M Schildkraut
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina. Cancer Control and Population Sciences, Duke Cancer Institute, Durham, North Carolina
| | - Ira Schwaab
- Institut für Humangenetik Wiesbaden, Wiesbaden, Germany
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Yurii B Shvetsov
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Nadeem Siddiqui
- Department of Gynaecological Oncology, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Weiva Sieh
- Department of Health Research and Policy-Epidemiology, Stanford University School of Medicine, Stanford, California
| | - Honglin Song
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Melissa C Southey
- Department of Pathology, University of Melbourne, Parkville, Victoria, Australia
| | | | - Ingvild L Tangen
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway. Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Soo-Hwang Teo
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia. University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia
| | - Kathryn L Terry
- Obstetrics and Gynecology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Harvard School of Public Health, Boston, Massachusetts
| | - Pamela J Thompson
- Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California. Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Agnieszka Timorek
- Department of Obstetrics, Gynecology, and Oncology, IInd Faculty of Medicine, Warsaw Medical University and Brodnowski Hospital, Warsaw, Poland
| | - Ya-Yu Tsai
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Anne M van Altena
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Nijmegen, the Netherlands
| | - Els Van Nieuwenhuysen
- Division of Gynecological Oncology, Department of Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Ignace Vergote
- Division of Gynecological Oncology, Department of Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Robert A Vierkant
- Department of Health Science Research, Mayo Clinic, Rochester, Minnesota
| | - Shan Wang-Gohrke
- Department of Obstetrics and Gynecology, University of Ulm, Ulm, Germany
| | - Christine Walsh
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Alice S Whittemore
- Department of Health Research and Policy-Epidemiology, Stanford University School of Medicine, Stanford, California
| | - Kristine G Wicklund
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Yin-Ling Woo
- University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia. Department of Obstetrics and Gynaecology, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia
| | - Xifeng Wu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anna Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Hannah Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Argyrios Ziogas
- Department of Epidemiology, Director of Genetic Epidemiology Research Institute, School of Medicine, University of California Irvine, Irvine, California
| | - Thomas A Sellers
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | | | - Matthew L Freedman
- Department of Medical Oncology, The Center for Functional Cancer Epigenetics, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Simon A Gayther
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
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14
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Song H, Dicks E, Ramus SJ, Tyrer JP, Intermaggio MP, Hayward J, Edlund CK, Conti D, Harrington P, Fraser L, Philpott S, Anderson C, Rosenthal A, Gentry-Maharaj A, Bowtell DD, Alsop K, Cicek MS, Cunningham JM, Fridley BL, Alsop J, Jimenez-Linan M, Høgdall E, Høgdall CK, Jensen A, Kjaer SK, Lubiński J, Huzarski T, Jakubowska A, Gronwald J, Poblete S, Lele S, Sucheston-Campbell L, Moysich KB, Odunsi K, Goode EL, Menon U, Jacobs IJ, Gayther SA, Pharoah PDP. Contribution of Germline Mutations in the RAD51B, RAD51C, and RAD51D Genes to Ovarian Cancer in the Population. J Clin Oncol 2015; 33:2901-7. [PMID: 26261251 PMCID: PMC4554751 DOI: 10.1200/jco.2015.61.2408] [Citation(s) in RCA: 232] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The aim of this study was to estimate the contribution of deleterious mutations in the RAD51B, RAD51C, and RAD51D genes to invasive epithelial ovarian cancer (EOC) in the population and in a screening trial of individuals at high risk of ovarian cancer. PATIENTS AND METHODS The coding sequence and splice site boundaries of the three RAD51 genes were sequenced and analyzed in germline DNA from a case-control study of 3,429 patients with invasive EOC and 2,772 controls as well as in 2,000 unaffected women who were BRCA1/BRCA2 negative from the United Kingdom Familial Ovarian Cancer Screening Study (UK_FOCSS) after quality-control analysis. RESULTS In the case-control study, we identified predicted deleterious mutations in 28 EOC cases (0.82%) compared with three controls (0.11%; P < .001). Mutations in EOC cases were more frequent in RAD51C (14 occurrences, 0.41%) and RAD51D (12 occurrences, 0.35%) than in RAD51B (two occurrences, 0.06%). RAD51C mutations were associated with an odds ratio of 5.2 (95% CI, 1.1 to 24; P = .035), and RAD51D mutations conferred an odds ratio of 12 (95% CI, 1.5 to 90; P = .019). We identified 13 RAD51 mutations (0.65%) in unaffected UK_FOCSS participants (RAD51C, n = 7; RAD51D, n = 5; and RAD51B, n = 1), which was a significantly greater rate than in controls (P < .001); furthermore, RAD51 mutation carriers were more likely than noncarriers to have a family history of ovarian cancer (P < .001). CONCLUSION These results confirm that RAD51C and RAD51D are moderate ovarian cancer susceptibility genes and suggest that they confer levels of risk of EOC that may warrant their use alongside BRCA1 and BRCA2 in routine clinical genetic testing.
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Affiliation(s)
- Honglin Song
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Ed Dicks
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Susan J Ramus
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Jonathan P Tyrer
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Maria P Intermaggio
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Jane Hayward
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Christopher K Edlund
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - David Conti
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Patricia Harrington
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Lindsay Fraser
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Susan Philpott
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Christopher Anderson
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Adam Rosenthal
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Aleksandra Gentry-Maharaj
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - David D Bowtell
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Kathryn Alsop
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Mine S Cicek
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Julie M Cunningham
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Brooke L Fridley
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Jennifer Alsop
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Mercedes Jimenez-Linan
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Estrid Høgdall
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Claus K Høgdall
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Allan Jensen
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Susanne Krüger Kjaer
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Jan Lubiński
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Tomasz Huzarski
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Anna Jakubowska
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Jacek Gronwald
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Samantha Poblete
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Shashi Lele
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Lara Sucheston-Campbell
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Kirsten B Moysich
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Kunle Odunsi
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Ellen L Goode
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Usha Menon
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Ian J Jacobs
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Simon A Gayther
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY.
| | - Paul D P Pharoah
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
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A targeted approach to genetic counseling in breast cancer patients: the experience of an Italian local project. TUMORI JOURNAL 2015; 102:45-50. [PMID: 26357973 DOI: 10.5301/tj.5000407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2015] [Indexed: 02/05/2023]
Abstract
AIMS AND BACKGROUND Patients with hereditary breast cancer (BC) may benefit from genetic counseling and testing for detection of causative mutations, definition of therapeutic and preventive strategies, and identification of at-risk relatives. Italy has few oncogenetic centers and genetic evaluation of all patients with BC is not feasible. Moreover, lack of uniformity in the selection of patients generates inappropriate referral to the geneticist. We designed a model that may represent a reproducible way to select patients at risk for hereditary BC, with the aims of rationalizing access to genetic centers and improving clinical management and surveillance. METHODS The genetic unit of a Cancer Center and the Departments of Oncology from 2 public Hospitals in Milan were involved in the project. After training sessions at the genetic unit, operators from the 2 hospitals evaluated all patients with BC attending a first oncologic visit, through a specific interview. Patients considered at risk of hereditary BC attended counseling at the genetic unit. RESULTS Of 419 patients, 61 (14.5%) were eligible for genetic counseling after the interview. Of these, 46 (10.9%) strictly met testing criteria. Overall, 52 (12.4%) patients underwent genetic counseling and 47 were tested for BRCA1/BRCA2 mutation. After genetic test results, the available options for treatment/surveillance were discussed by a multidisciplinary team, according to the level of genetic risk. CONCLUSIONS It is possible to improve the process of referring patients with suspected hereditary BC for genetic risk assessment. The application of clinical screening reduced the genetics unit's workload and enabled optimization of time and resources.
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Spees CK, Kelleher KJ, Abaza R, Clinton SK. Prostate Cancer and Li-Fraumeni Syndrome: Implications for Screening and Therapy. Urol Case Rep 2015; 3:21-3. [PMID: 26793489 PMCID: PMC4714266 DOI: 10.1016/j.eucr.2015.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 01/05/2015] [Indexed: 01/22/2023] Open
Abstract
Li-Fraumeni Syndrome (LFS) is an autosomal dominant genetic disorder associated with mutations in the TP53 gene and characterized by a propensity to develop a variety of malignancies resulting in a shortened lifespan. We report a case of prostate cancer in a 50 year old male with LFS. Experimental studies suggest that TP53 mutations in prostate cancer are associated with therapeutic resistance to radiation, chemotherapy, and anti-androgens, implying that LFS men may experience more aggressive cancer biology with implications for therapeutic decisions. The potential of prostate cancer to develop earlier in LFS favors institution of screening at earlier ages.
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Affiliation(s)
- Colleen K Spees
- Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA; Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Kelly J Kelleher
- College of Public Health, The Ohio State University, Columbus, OH, USA; Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ronney Abaza
- Department of Urology, The Ohio State University College of Medicine, Columbus, OH, USA; Robotic Urologic Surgery, OhioHealth Dublin Methodist Hospital, Dublin, OH, USA
| | - Steven K Clinton
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA; Department of Urology, The Ohio State University College of Medicine, Columbus, OH, USA; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
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Marie Lewis K. Identifying hereditary cancer: Genetic counseling and cancer risk assessment. Curr Probl Cancer 2014; 38:216-25. [DOI: 10.1016/j.currproblcancer.2014.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18
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van den Broek AJ, de Ruiter K, van 't Veer LJ, Tollenaar RAEM, van Leeuwen FE, Verhoef S, Schmidt MK. Evaluation of the Dutch BRCA1/2 clinical genetic center referral criteria in an unselected early breast cancer population. Eur J Hum Genet 2014; 23:588-95. [PMID: 25138101 PMCID: PMC4402636 DOI: 10.1038/ejhg.2014.161] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 06/26/2014] [Accepted: 07/09/2014] [Indexed: 12/19/2022] Open
Abstract
In this study, we evaluated the diagnostic value of the Dutch Clinical Genetic Center (CGC) referral guidelines for BRCA1/2 mutation testing in 903 early breast cancer patients, unselected for family history, diagnosed in a cancer hospital before the age of 50 years in 1974-2002; most prevalent Dutch pathogenic BRCA1/2 mutations had been analyzed on coded DNA in a research setting. Forty-nine (5.4%) of the patients were proven to be BRCA1/2 mutation carriers. We found that 78% and 69% of BRCA1 and BRCA2 mutation carriers identified met the criteria for referral to the CGC based on age, family history and synchronous multiple tumors; reflected by a combined sensitivity of 75.5% and specificity of 63.2%. More than half of the BRCA1 mutation carriers, that is, 58% had a triple-negative tumor. The highest AUC was obtained by shifting the age at diagnosis threshold criterion from 40 to 35 years and by adding a 'triple-negative breast cancer' criterion with an age threshold of 45 years; the specificity increased to 71.2%, whereas the sensitivity remained the same; that is, a referral of fewer patients will lead to the identification of at least the same number of BRCA1/2 mutation carriers. Two-thirds of the BRCA1/2 mutation carriers identified in this research setting had been referred for counseling and testing. Our results indicate that, awaiting a possibly more extended mutation screening of all breast cancer patients, the triple-negative status of a breast cancer should be added to the CGC referral criteria.
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Affiliation(s)
- Alexandra J van den Broek
- 1] Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands [2] Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Karen de Ruiter
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Laura J van 't Veer
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Rob A E M Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Flora E van Leeuwen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Senno Verhoef
- Family Cancer Clinic, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Marjanka K Schmidt
- 1] Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands [2] Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
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Bonaïti B, Alarcon F, Andrieu N, Bonadona V, Dondon MG, Pennec S, Stoppa-Lyonnet D, Bonaïti-Pellié C, Perdry H. A new scoring system in cancer genetics: application to criteria for BRCA1 and BRCA2 mutation screening. J Med Genet 2013; 51:114-21. [PMID: 24343917 DOI: 10.1136/jmedgenet-2013-101674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND In hereditary forms of cancer due to mutations of genes such as BRCA1 and BRCA2, methods have been proposed to predict the presence of a mutation in a family. METHODS Relying on carriage probability computation is the most predictive, but scores are a good proxy and avoid using computer software. An empirical method, the Manchester scoring system, has been elaborated for BRCA1 and BRCA2 mutation identification. We propose a general scoring system based on a transformation of the carriage probability. Up to an approximation, the transformed carriage probability becomes an additive score. We applied this new scoring system to the diagnosis of BRCA1-associated and BRCA2-associated breast-ovarian cancer predisposition. Using simulations, its performance was evaluated and compared with that of the Manchester scoring system and of the exact probability. Finally, the score system was used on a sample of 4563 families screened for BRCA1 and BRCA2 mutations. RESULTS The performance of the new scoring system was superior to the Manchester scoring system, but the probability computation remained the most predictive. The better performance of the new scoring system was attributed to accounting for unaffected family members and for the degree of kinship of relatives with the proband. CONCLUSIONS The new scoring system has a theoretical basis and may be applied to any cancer family syndrome and, more generally, to any disease with monogenic subentities, in which the causal gene mutations have been identified. It will be easily modified when additional predictive factors are found.
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Pu X, Ye Y, Wu X. Development and validation of risk models and molecular diagnostics to permit personalized management of cancer. Cancer 2013; 120:11-9. [PMID: 24114238 DOI: 10.1002/cncr.28393] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 08/25/2013] [Accepted: 08/29/2013] [Indexed: 01/29/2023]
Abstract
Despite the advances made in cancer management over the past few decades, improvements in cancer diagnosis and prognosis are still poor, highlighting the need for individualized strategies. Toward this goal, risk prediction models and molecular diagnostic tools have been developed, tailoring each step of risk assessment from diagnosis to treatment and clinical outcomes based on the individual's clinical, epidemiological, and molecular profiles. These approaches hold increasing promise for delivering a new paradigm to maximize the efficiency of cancer surveillance and efficacy of treatment. However, they require stringent study design, methodology development, comprehensive assessment of biomarkers and risk factors, and extensive validation to ensure their overall usefulness for clinical translation. In the current study, the authors conducted a systematic review using breast cancer as an example and provide general guidelines for risk prediction models and molecular diagnostic tools, including development, assessment, and validation.
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Affiliation(s)
- Xia Pu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Cadiz F, Kuerer HM, Puga J, Camacho J, Cunill E, Arun B. Establishing a program for individuals at high risk for breast cancer. J Cancer 2013; 4:433-46. [PMID: 23833688 PMCID: PMC3701813 DOI: 10.7150/jca.6481] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 05/23/2013] [Indexed: 12/13/2022] Open
Abstract
Our need to create a program for individuals at high risk for breast cancer development led us to research the available data on such programs. In this paper, we summarize our findings and our thinking process as we developed our own program. Breast cancer incidence is increasing worldwide. Even though there are known risk factors for breast cancer development, approximately 60% of patients with breast cancer have no known risk factor, although this situation will probably change with further research, especially in genetics. For patients with risk factors based on personal or family history, different models are available for assessing and quantifying risk. Assignment of risk levels permits tailored screening and risk reduction strategies. Potential benefits of specialized programs for women with high breast cancer risk include more cost -effective interventions as a result of patient stratification on the basis of risk; generation of valuable data to advance science; and differentiation of breast programs from other breast cancer units, which can result in increased revenue that can be directed to further improvements in patient care. Guidelines for care of patients at high risk for breast cancer are available from various groups. However, running a high-risk breast program involves much more than applying a guideline. Each high-risk program needs to be designed by its institution with consideration of local resources and country legislation, especially related to genetic issues. Development of a successful high-risk program includes identifying strengths, weaknesses, opportunities, and threats; developing a promotion plan; choosing a risk assessment tool; defining "high risk"; and planning screening and risk reduction strategies for the specific population served by the program. The information in this article may be useful for other institutions considering creation of programs for patients with high breast cancer risk.
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Affiliation(s)
- Fernando Cadiz
- 1. Department of Gynecology and Obstetrics, Breast Cancer Center, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Henry M. Kuerer
- 2. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Julio Puga
- 1. Department of Gynecology and Obstetrics, Breast Cancer Center, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Jamile Camacho
- 1. Department of Gynecology and Obstetrics, Breast Cancer Center, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Eduardo Cunill
- 1. Department of Gynecology and Obstetrics, Breast Cancer Center, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Banu Arun
- 3. Clinical Cancer Genetics Service, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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22
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Pearce CL, Rossing MA, Lee AW, Ness RB, Webb PM, Chenevix-Trench G, Jordan SM, Stram DA, Chang-Claude J, Hein R, Nickels S, Lurie G, Thompson PJ, Carney ME, Goodman MT, Moysich K, Hogdall E, Jensen A, Goode EL, Fridley BL, Cunningham JM, Vierkant RA, Weber RP, Ziogas A, Anton-Culver H, Gayther SA, Gentry-Maharaj A, Menon U, Ramus SJ, Brinton L, Wentzensen N, Lissowska J, Garcia-Closas M, Massuger LFAG, Kiemeney LALM, Van Altena AM, Aben KKH, Berchuck A, Doherty JA, Iversen E, McGuire V, Moorman PG, Pharoah P, Pike MC, Risch H, Sieh W, Stram DO, Terry KL, Whittemore A, Wu AH, Schildkraut JM, Kjaer SK. Combined and interactive effects of environmental and GWAS-identified risk factors in ovarian cancer. Cancer Epidemiol Biomarkers Prev 2013; 22:880-90. [PMID: 23462924 PMCID: PMC3963289 DOI: 10.1158/1055-9965.epi-12-1030-t] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There are several well-established environmental risk factors for ovarian cancer, and recent genome-wide association studies have also identified six variants that influence disease risk. However, the interplay between such risk factors and susceptibility loci has not been studied. METHODS Data from 14 ovarian cancer case-control studies were pooled, and stratified analyses by each environmental risk factor with tests for heterogeneity were conducted to determine the presence of interactions for all histologic subtypes. A genetic "risk score" was created to consider the effects of all six variants simultaneously. A multivariate model was fit to examine the association between all environmental risk factors and genetic risk score on ovarian cancer risk. RESULTS Among 7,374 controls and 5,566 cases, there was no statistical evidence of interaction between the six SNPs or genetic risk score and the environmental risk factors on ovarian cancer risk. In a main effects model, women in the highest genetic risk score quartile had a 65% increased risk of ovarian cancer compared with women in the lowest [95% confidence interval (CI), 1.48-1.84]. Analyses by histologic subtype yielded risk differences across subtype for endometriosis (Phet < 0.001), parity (Phet < 0.01), and tubal ligation (Phet = 0.041). CONCLUSIONS The lack of interactions suggests that a multiplicative model is the best fit for these data. Under such a model, we provide a robust estimate of the effect of each risk factor that sets the stage for absolute risk prediction modeling that considers both environmental and genetic risk factors. Further research into the observed differences in risk across histologic subtype is warranted.
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Affiliation(s)
- Celeste Leigh Pearce
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
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23
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Pharoah PDP, Tsai YY, Ramus SJ, Phelan CM, Goode EL, Lawrenson K, Buckley M, Fridley BL, Tyrer JP, Shen H, Weber R, Karevan R, Larson MC, Song H, Tessier DC, Bacot F, Vincent D, Cunningham JM, Dennis J, Dicks E, Aben KK, Anton-Culver H, Antonenkova N, Armasu SM, Baglietto L, Bandera EV, Beckmann MW, Birrer MJ, Bloom G, Bogdanova N, Brenton JD, Brinton LA, Brooks-Wilson A, Brown R, Butzow R, Campbell I, Carney ME, Carvalho RS, Chang-Claude J, Chen YA, Chen Z, Chow WH, Cicek MS, Coetzee G, Cook LS, Cramer DW, Cybulski C, Dansonka-Mieszkowska A, Despierre E, Doherty JA, Dörk T, du Bois A, Dürst M, Eccles D, Edwards R, Ekici AB, Fasching PA, Fenstermacher D, Flanagan J, Gao YT, Garcia-Closas M, Gentry-Maharaj A, Giles G, Gjyshi A, Gore M, Gronwald J, Guo Q, Halle MK, Harter P, Hein A, Heitz F, Hillemanns P, Hoatlin M, Høgdall E, Høgdall CK, Hosono S, Jakubowska A, Jensen A, Kalli KR, Karlan BY, Kelemen LE, Kiemeney LA, Kjaer SK, Konecny GE, Krakstad C, Kupryjanczyk J, Lambrechts D, Lambrechts S, Le ND, Lee N, Lee J, Leminen A, Lim BK, Lissowska J, Lubiński J, Lundvall L, Lurie G, Massuger LFAG, Matsuo K, McGuire V, McLaughlin JR, Menon U, Modugno F, Moysich KB, Nakanishi T, Narod SA, Ness RB, Nevanlinna H, Nickels S, Noushmehr H, Odunsi K, Olson S, Orlow I, Paul J, Pejovic T, Pelttari LM, Permuth-Wey J, Pike MC, Poole EM, Qu X, Risch HA, Rodriguez-Rodriguez L, Rossing MA, Rudolph A, Runnebaum I, Rzepecka IK, Salvesen HB, Schwaab I, Severi G, Shen H, Shridhar V, Shu XO, Sieh W, Southey MC, Spellman P, Tajima K, Teo SH, Terry KL, Thompson PJ, Timorek A, Tworoger SS, van Altena AM, van den Berg D, Vergote I, Vierkant RA, Vitonis AF, Wang-Gohrke S, Wentzensen N, Whittemore AS, Wik E, Winterhoff B, Woo YL, Wu AH, Yang HP, Zheng W, Ziogas A, Zulkifli F, Goodman MT, Hall P, Easton DF, Pearce CL, Berchuck A, Chenevix-Trench G, Iversen E, Monteiro ANA, Gayther SA, Schildkraut JM, Sellers TA. GWAS meta-analysis and replication identifies three new susceptibility loci for ovarian cancer. Nat Genet 2013; 45:362-70, 370e1-2. [PMID: 23535730 PMCID: PMC3693183 DOI: 10.1038/ng.2564] [Citation(s) in RCA: 288] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 01/30/2013] [Indexed: 12/16/2022]
Abstract
Genome-wide association studies (GWAS) have identified four susceptibility loci for epithelial ovarian cancer (EOC), with another two suggestive loci reaching near genome-wide significance. We pooled data from a GWAS conducted in North America with another GWAS from the UK. We selected the top 24,551 SNPs for inclusion on the iCOGS custom genotyping array. We performed follow-up genotyping in 18,174 individuals with EOC (cases) and 26,134 controls from 43 studies from the Ovarian Cancer Association Consortium. We validated the two loci at 3q25 and 17q21 that were previously found to have associations close to genome-wide significance and identified three loci newly associated with risk: two loci associated with all EOC subtypes at 8q21 (rs11782652, P = 5.5 × 10(-9)) and 10p12 (rs1243180, P = 1.8 × 10(-8)) and another locus specific to the serous subtype at 17q12 (rs757210, P = 8.1 × 10(-10)). An integrated molecular analysis of genes and regulatory regions at these loci provided evidence for functional mechanisms underlying susceptibility and implicated CHMP4C in the pathogenesis of ovarian cancer.
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Affiliation(s)
- Paul D P Pharoah
- The Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK.
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24
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Shen H, Fridley BL, Song H, Lawrenson K, Cunningham JM, Ramus SJ, Cicek MS, Tyrer J, Stram D, Larson MC, Köbel M, Ziogas A, Zheng W, Yang HP, Wu AH, Wozniak EL, Ling Woo Y, Winterhoff B, Wik E, Whittemore AS, Wentzensen N, Palmieri Weber R, Vitonis AF, Vincent D, Vierkant RA, Vergote I, Van Den Berg D, Van Altena AM, Tworoger SS, Thompson PJ, Tessier DC, Terry KL, Teo SH, Templeman C, Stram DO, Southey MC, Sieh W, Siddiqui N, Shvetsov YB, Shu XO, Shridhar V, Wang-Gohrke S, Severi G, Schwaab I, Salvesen HB, Rzepecka IK, Runnebaum IB, Anne Rossing M, Rodriguez-Rodriguez L, Risch HA, Renner SP, Poole EM, Pike MC, Phelan CM, Pelttari LM, Pejovic T, Paul J, Orlow I, Zawiah Omar S, Olson SH, Odunsi K, Nickels S, Nevanlinna H, Ness RB, Narod SA, Nakanishi T, Moysich KB, Monteiro AN, Moes-Sosnowska J, Modugno F, Menon U, McLaughlin JR, McGuire V, Matsuo K, Mat Adenan NA, Massuger LF, Lurie G, Lundvall L, Lubiński J, Lissowska J, Levine DA, Leminen A, Lee AW, Le ND, Lambrechts S, Lambrechts D, Kupryjanczyk J, Krakstad C, Konecny GE, Krüger Kjaer S, Kiemeney LA, Kelemen LE, Keeney GL, Karlan BY, Karevan R, Kalli KR, Kajiyama H, Ji BT, Jensen A, Jakubowska A, Iversen E, Hosono S, Høgdall CK, Høgdall E, Hoatlin M, Hillemanns P, Heitz F, Hein R, Harter P, Halle MK, Hall P, Gronwald J, Gore M, Goodman MT, Giles GG, Gentry-Maharaj A, Garcia-Closas M, Flanagan JM, Fasching PA, Ekici AB, Edwards R, Eccles D, Easton DF, Dürst M, du Bois A, Dörk T, Doherty JA, Despierre E, Dansonka-Mieszkowska A, Cybulski C, Cramer DW, Cook LS, Chen X, Charbonneau B, Chang-Claude J, Campbell I, Butzow R, Bunker CH, Brueggmann D, Brown R, Brooks-Wilson A, Brinton LA, Bogdanova N, Block MS, Benjamin E, Beesley J, Beckmann MW, Bandera EV, Baglietto L, Bacot F, Armasu SM, Antonenkova N, Anton-Culver H, Aben KK, Liang D, Wu X, Lu K, Hildebrandt MA, Schildkraut JM, Sellers TA, Huntsman D, Berchuck A, Chenevix-Trench G, Gayther SA, Pharoah PD, Laird PW, Goode EL, Leigh Pearce C. Epigenetic analysis leads to identification of HNF1B as a subtype-specific susceptibility gene for ovarian cancer. Nat Commun 2013; 4:1628. [PMID: 23535649 PMCID: PMC3848248 DOI: 10.1038/ncomms2629] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 02/21/2013] [Indexed: 12/19/2022] Open
Abstract
HNF1B is overexpressed in clear cell epithelial ovarian cancer, and we observed epigenetic silencing in serous epithelial ovarian cancer, leading us to hypothesize that variation in this gene differentially associates with epithelial ovarian cancer risk according to histological subtype. Here we comprehensively map variation in HNF1B with respect to epithelial ovarian cancer risk and analyse DNA methylation and expression profiles across histological subtypes. Different single-nucleotide polymorphisms associate with invasive serous (rs7405776 odds ratio (OR)=1.13, P=3.1 × 10(-10)) and clear cell (rs11651755 OR=0.77, P=1.6 × 10(-8)) epithelial ovarian cancer. Risk alleles for the serous subtype associate with higher HNF1B-promoter methylation in these tumours. Unmethylated, expressed HNF1B, primarily present in clear cell tumours, coincides with a CpG island methylator phenotype affecting numerous other promoters throughout the genome. Different variants in HNF1B associate with risk of serous and clear cell epithelial ovarian cancer; DNA methylation and expression patterns are also notably distinct between these subtypes. These findings underscore distinct mechanisms driving different epithelial ovarian cancer histological subtypes.
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Affiliation(s)
- Hui Shen
- USC Epigenome Center, Keck School of Medicine, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Brooke L. Fridley
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, 66160 Kansas USA
| | - Honglin Song
- Department of Oncology, University of Cambridge, Cambridge, CB1 8RN UK
| | - Kate Lawrenson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Julie M. Cunningham
- Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Susan J. Ramus
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Mine S. Cicek
- Division of Epidemiology, Department of Health Science Research, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Jonathan Tyrer
- Department of Oncology, University of Cambridge, Cambridge, CB1 8RN UK
| | - Douglas Stram
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Melissa C. Larson
- Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, Calgary Laboratory Services, University of Calgary, Calgary, T2N 2T9 Alberta Canada
| | | | - Argyrios Ziogas
- Department of Epidemiology, Center for Cancer Genetics Research and Prevention, School of Medicine, University of California Irvine, Irvine, 92697 California USA
| | - Wei Zheng
- Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, 37232 Tennessee USA
| | - Hannah P. Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, 20892 Maryland USA
| | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Eva L. Wozniak
- Gynaecological Cancer Research Centre, UCL EGA Institute for Women's Health, London, NW1 2BU UK
| | - Yin Ling Woo
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Affiliated to UM Cancer Research Institute, University of Malaya, Kuala Lumpur, 59100 Malaysia
| | - Boris Winterhoff
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Elisabeth Wik
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, HB 5006 Norway
- Department of Clinical Science, University of Bergen, Bergen, HB 5006 Norway
| | - Alice S. Whittemore
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, 94305 California USA
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, 20892 Maryland USA
| | - Rachel Palmieri Weber
- Department of Community and Family Medicine, Duke University Medical Center, Durham, 27708 North Carolina USA
| | - Allison F. Vitonis
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, 02115 Massachusetts USA
| | | | - Robert A. Vierkant
- Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Ignace Vergote
- Vesalius Research Center, VIB, Leuven, 3000 Belgium
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer Institute, University Hospitals Leuven, Leuven, 3000 Belgium
| | - David Van Den Berg
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Anne M. Van Altena
- Department of Gynaecology, Radboud University Medical Centre, Nijmegen, HB 6500 The Netherlands
| | - Shelley S. Tworoger
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, 02115 Massachusetts USA
- Department of Epidemiology, Harvard School of Public Health, Boston, 02115 Massachusetts USA
| | - Pamela J. Thompson
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Hawaii, 96813 USA
| | | | - Kathryn L. Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, 02115 Massachusetts USA
- Department of Epidemiology, Harvard School of Public Health, Boston, 02115 Massachusetts USA
| | - Soo-Hwang Teo
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, 47500 Malaysia
- University Malaya Cancer Research Institute, University Malaya Medical Centre, University of Malaya, Kuala Lumpur, 59100 Malaysia
| | - Claire Templeman
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, 90033 California USA
| | - Daniel O. Stram
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Melissa C. Southey
- Department of Pathology, Genetic Epidemiology Laboratory, University of Melbourne, Melbourne, VIC 3053 Victoria Australia
| | - Weiva Sieh
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, 94305 California USA
| | - Nadeem Siddiqui
- Department of Gynaecological Oncology, Glasgow Royal Infirmary, Glasgow, G4 0SF UK
| | - Yurii B. Shvetsov
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Hawaii, 96813 USA
| | - Xiao-Ou Shu
- Department of Epidemiology, Center for Cancer Genetics Research and Prevention, School of Medicine, University of California Irvine, Irvine, 92697 California USA
| | - Viji Shridhar
- Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Shan Wang-Gohrke
- Department of Obstetrics and Gynecology, University of Ulm, Ulm, 89091 Germany
| | - Gianluca Severi
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC 3053 Victoria Australia
- Centre for Molecular, Environmental, Genetic and Analytical Epidemiology, University of Melbourne, Melbourne, VIC 3010 Victoria Australia
| | - Ira Schwaab
- Institut für Humangenetik Wiesbaden, Wiesbaden, 65187 Germany
| | - Helga B. Salvesen
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, HB 5006 Norway
- Department of Clinical Science, University of Bergen, Bergen, HB 5006 Norway
| | - Iwona K. Rzepecka
- Department of Molecular Pathology, Maria Sklodowska-Curie Memorial Cancer Center, Institute of Oncology, Warsaw, 02-781 Poland
| | - Ingo B. Runnebaum
- Department of Gynecology and Obstetrics, Jena University Hospital, Jena, 07743 Germany
| | - Mary Anne Rossing
- Division of Public Health Sciences, Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, 98109 Washington USA
- Department of Epidemiology, University of Washington, Seattle, 98109 Washington USA
| | - Lorna Rodriguez-Rodriguez
- Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, 08901 New Jersey USA
| | - Harvey A. Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, 06520 Connecticut USA
| | - Stefan P. Renner
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center, Erlangen, 91054 Germany
| | - Elizabeth M. Poole
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, 02115 Massachusetts USA
- Department of Epidemiology, Harvard School of Public Health, Boston, 02115 Massachusetts USA
| | - Malcolm C. Pike
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, 10065 New York USA
| | - Catherine M. Phelan
- Division of Population Sciences, Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, 33612 Florida USA
| | - Liisa M. Pelttari
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00530 Finland
| | - Tanja Pejovic
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, 97239 Oregon USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, 97239 Oregon USA
| | - James Paul
- Beatson West of Scotland Cancer Centre, Glasgow, G12 0YN UK
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, 10065 New York USA
| | - Siti Zawiah Omar
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Affiliated to UM Cancer Research Institute, University of Malaya, Kuala Lumpur, 59100 Malaysia
| | - Sara H. Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, 10065 New York USA
| | - Kunle Odunsi
- Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, 14263 New York USA
| | - Stefan Nickels
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, 69120 Germany
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00530 Finland
| | - Roberta B. Ness
- School of Public Health, University of Texas, Houston, 77030 Texas USA
| | - Steven A. Narod
- Women’s College Research Institute, University of Toronto, Toronto, M5G IN8 Ontario Canada
| | - Toru Nakanishi
- Department of Gynecologic Oncology, Aichi Cancer Center Central Hospital, Nagoya, 464-8681 Japan
| | - Kirsten B. Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, 14263 New York USA
| | - Alvaro N.A. Monteiro
- Division of Population Sciences, Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, 33612 Florida USA
| | - Joanna Moes-Sosnowska
- Department of Molecular Pathology, Maria Sklodowska-Curie Memorial Cancer Center, Institute of Oncology, Warsaw, 02-781 Poland
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, 15213 Pennsylvania USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, 15213 Pennsylvania USA
- Women’s Cancer Research Program, Magee-Womens Research Institute, University of Pittsburgh Cancer Institute, Pittsburgh, 15213 Pennsylvania USA
| | - Usha Menon
- Gynaecological Cancer Research Centre, UCL EGA Institute for Women's Health, London, NW1 2BU UK
| | - John R. McLaughlin
- Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, M5T 3M7 Ontario Canada
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, M5G IX5 Ontario Canada
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, 94305 California USA
| | - Keitaro Matsuo
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, 464-8681 Japan
| | - Noor Azmi Mat Adenan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Affiliated to UM Cancer Research Institute, University of Malaya, Kuala Lumpur, 59100 Malaysia
| | - Leon F.A.G Massuger
- Department of Gynaecology, Radboud University Medical Centre, Nijmegen, HB 6500 The Netherlands
| | - Galina Lurie
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Hawaii, 96813 USA
| | - Lene Lundvall
- Gynecologic Clinic, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, DK-2100 Denmark
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, 70-115 Poland
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, Maria Sklodowska-Curie Memorial Cancer Center, Warsaw, 02-781 Poland
| | - Douglas A. Levine
- Department of Surgery, Gynecology Service, Memorial Sloan-Kettering Cancer Center, New York, 10021 New York USA
| | - Arto Leminen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00530 Finland
| | - Alice W. Lee
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Nhu D. Le
- Cancer Control Research, BC Cancer Agency, Vancouver, G12 0YN British Columbia Canada
| | - Sandrina Lambrechts
- Vesalius Research Center, VIB, Leuven, 3000 Belgium
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer Institute, University Hospitals Leuven, Leuven, 3000 Belgium
- Department of Oncology, Laboratory for Translational Genetics, University of Leuven, Leuven, 3000 Belgium
| | - Diether Lambrechts
- Vesalius Research Center, VIB, Leuven, 3000 Belgium
- Department of Oncology, Laboratory for Translational Genetics, University of Leuven, Leuven, 3000 Belgium
| | - Jolanta Kupryjanczyk
- Department of Molecular Pathology, Maria Sklodowska-Curie Memorial Cancer Center, Institute of Oncology, Warsaw, 02-781 Poland
| | - Camilla Krakstad
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, HB 5006 Norway
- Department of Clinical Science, University of Bergen, Bergen, HB 5006 Norway
| | - Gottfried E. Konecny
- Division of Hematology and Oncology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, 90095 California USA
| | - Susanne Krüger Kjaer
- Gynecologic Clinic, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, DK-2100 Denmark
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, DK-2100 Denmark
| | - Lambertus A. Kiemeney
- Department of Epidemiology, Biostatistics and HTA, Radboud University Medical Centre, Nijmegen, HB 6500 Netherlands
- Department of Urology, Radboud University Medical Centre, Nijmegen, HB 6500 The Netherlands
- Comprehensive Cancer Center, Utrecht, 1066CX The Netherlands
| | - Linda E. Kelemen
- Department of Population Health Research, Alberta Health Services-Cancer Care, Calgary, T2N 2T9 Alberta Canada
- Department of Medical Genetics and Oncology, University of Calgary, Calgary, T2N 2T9 Alberta Canada
| | - Gary L. Keeney
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Beth Y. Karlan
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, 90048 California USA
| | - Rod Karevan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Kimberly R. Kalli
- Department of Medical Oncology, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, 464-8601 Japan
| | - Bu-Tian Ji
- Division of Cancer Etiology and Genetics, National Cancer Institute, Bethesda, 20892 Maryland USA
| | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, DK-2100 Denmark
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, 70-115 Poland
| | - Edwin Iversen
- Department of Statistical Science, Duke University, Durham, 27708 North Carolina USA
| | - Satoyo Hosono
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, 464-8681 Japan
| | - Claus K. Høgdall
- Gynecologic Clinic, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, DK-2100 Denmark
| | - Estrid Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, DK-2100 Denmark
- Department of Pathology, Molecular Unit, Herlev Hospital, University of Copenhagen, Copenhagen, 2730 Denmark
| | - Maureen Hoatlin
- Department of Biochemistry and Molecular Biology, Oregon Health and Science University, Portland, 97239 Oregon USA
| | - Peter Hillemanns
- Clinics of Obstetrics and Gynaecology, Hannover Medical School, Hannover, 30625 Germany
| | - Florian Heitz
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, 45136 Germany
- Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Klinik, Wiesbaden, 65199 Germany
| | - Rebecca Hein
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, 69120 Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, PMV Research Group, University of Cologne, Cologne, 50923 Germany
| | - Philipp Harter
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, 45136 Germany
- Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Klinik, Wiesbaden, 65199 Germany
| | - Mari K. Halle
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, HB 5006 Norway
- Department of Clinical Science, University of Bergen, Bergen, HB 5006 Norway
| | - Per Hall
- Department of Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171-77 Sweden
| | - Jacek Gronwald
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, 70-115 Poland
| | - Martin Gore
- Gynecological Oncology Unit, Royal Marsden Hospital, London, SW3 6JJ UK
| | - Marc T. Goodman
- Cedars Sinai Medical Center, Samuel Oschin Comprehensive Cancer Center Institute, Los Angeles, 90048 California USA
| | - Graham G. Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC 3053 Victoria Australia
- Centre for Molecular, Environmental, Genetic and Analytical Epidemiology, University of Melbourne, Melbourne, VIC 3010 Victoria Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3806 Victoria Australia
| | | | - Montserrat Garcia-Closas
- Division of Genetics and Epidemiology, Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, SW7 3RP UK
| | - James M. Flanagan
- Department of Surgery and Cancer, Imperial College London, London, SW7 2AZ UK
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center, Erlangen, 91054 Germany
- Division of Hematology and Oncology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, 90095 California USA
| | - Arif B. Ekici
- Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, 91054 Germany
| | - Robert Edwards
- Maggee Women’s Hospital, Pittsburg, 15213 Pennsylvania USA
| | - Diana Eccles
- Faculty of Medicine, University of Southampton, University Hospital Southampton, Southampton, S017 1BJ UK
| | - Douglas F. Easton
- Department of Oncology, University of Cambridge, Cambridge, CB1 8RN UK
| | - Matthias Dürst
- Department of Gynecology and Obstetrics, Jena University Hospital, Jena, 07743 Germany
| | - Andreas du Bois
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, 45136 Germany
- Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Klinik, Wiesbaden, 65199 Germany
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, 30625 Germany
| | - Jennifer A. Doherty
- Section of Biostatistics and Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, 03755 New Hampshire USA
| | - Evelyn Despierre
- Vesalius Research Center, VIB, Leuven, 3000 Belgium
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer Institute, University Hospitals Leuven, Leuven, 3000 Belgium
- Department of Oncology, Laboratory for Translational Genetics, University of Leuven, Leuven, 3000 Belgium
| | - Agnieszka Dansonka-Mieszkowska
- Department of Molecular Pathology, Maria Sklodowska-Curie Memorial Cancer Center, Institute of Oncology, Warsaw, 02-781 Poland
| | - Cezary Cybulski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, 70-115 Poland
| | - Daniel W. Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, 02115 Massachusetts USA
- Department of Epidemiology, Harvard School of Public Health, Boston, 02115 Massachusetts USA
| | - Linda S. Cook
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, University of New Mexico, Albuquerque, 87131 New Mexico USA
| | - Xiaoqing Chen
- Department of Genetics, Queensland Institute of Medical Research, Herston, QLD 4006 Queensland Australia
| | - Bridget Charbonneau
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, University of New Mexico, Albuquerque, 87131 New Mexico USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, 69120 Germany
| | - Ian Campbell
- Research Division, Peter MacCallum Cancer Centre, Cancer Genetics Laboratory, Melbourne, VIC 3002 Victoria Australia
- Department of Pathology, University of Melbourne, Parkville, VIC 3053 Victoria Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC 3002 Victoria Australia
| | - Ralf Butzow
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00530 Finland
- Department of Pathology, Helsinki University Central Hospital, Helsinki, 00530 Finland
| | - Clareann H. Bunker
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, 15213 Pennsylvania USA
| | - Doerthe Brueggmann
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, 90033 California USA
| | - Robert Brown
- Department of Surgery and Cancer, Imperial College London, London, SW7 2AZ UK
| | - Angela Brooks-Wilson
- Genome Sciences Centre, BC Cancer Agency, Vancouver, V52 1L3 British Columbia Canada
| | - Louise A. Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, 20892 Maryland USA
| | - Natalia Bogdanova
- Gynaecology Research Unit, Hannover Medical School, Hannover, 30625 Germany
| | - Matthew S. Block
- Department of Medical Oncology, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Elizabeth Benjamin
- Department of Pathology, Cancer Institute, University College London, London, WC1E 6JJ UK
| | - Jonathan Beesley
- Department of Genetics, Queensland Institute of Medical Research, Herston, QLD 4006 Queensland Australia
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center, Erlangen, 91054 Germany
| | - Elisa V. Bandera
- Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, 08901 New Jersey USA
| | - Laura Baglietto
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC 3053 Victoria Australia
- Centre for Molecular, Environmental, Genetic and Analytical Epidemiology, University of Melbourne, Melbourne, VIC 3010 Victoria Australia
| | | | - Sebastian M. Armasu
- Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Natalia Antonenkova
- Belarusian Institute for Oncology and Medical Radiology Aleksandrov N.N., Minsk, 223040 Belarus
| | - Hoda Anton-Culver
- Department of Epidemiology, Center for Cancer Genetics Research and Prevention, School of Medicine, University of California Irvine, Irvine, 92697 California USA
| | - Katja K. Aben
- Department of Epidemiology, Biostatistics and HTA, Radboud University Medical Centre, Nijmegen, HB 6500 Netherlands
- Comprehensive Cancer Center, Utrecht, 1066CX The Netherlands
| | - Dong Liang
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, 77044 Texas USA
| | - Xifeng Wu
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, 77030 Texas USA
| | - Karen Lu
- Department of Gynecologic Oncology, University of Texas MD Anderson Cancer Center, Houston, 77030 Texas USA
| | | | | | - Australian Cancer Study
- Department of Genetics, Queensland Institute of Medical Research, Herston, QLD 4006 Queensland Australia
| | - Joellen M. Schildkraut
- Department of Community and Family Medicine, Duke University Medical Center, Durham, 27708 North Carolina USA
- Cancer Prevention, Detection and Control Research Program, Duke Cancer Institute, Durham, 27708 North Carolina USA
| | - Thomas A. Sellers
- Division of Population Sciences, Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, 33612 Florida USA
| | - David Huntsman
- Department of Pathology, Vancouver General Hospital, BC Cancer Agency, Vancouver, V5Z 4E6 British Columbia Canada
| | - Andrew Berchuck
- Gynecologic Cancer Program, Duke Cancer Institute, Durham, 27708 North Carolina USA
| | - Georgia Chenevix-Trench
- Department of Genetics, Queensland Institute of Medical Research, Herston, QLD 4006 Queensland Australia
| | - Simon A. Gayther
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Paul D.P. Pharoah
- Department of Oncology, University of Cambridge, Cambridge, CB1 8RN UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN UK
| | - Peter W. Laird
- USC Epigenome Center, Keck School of Medicine, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
| | - Ellen L. Goode
- Division of Epidemiology, Department of Health Science Research, Mayo Clinic, Rochester, 55905 Minnesota USA
| | - Celeste Leigh Pearce
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, 90033 California USA
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Role of DNA repair and cell cycle control genes in ovarian cancer susceptibility. Mol Biol Rep 2013; 40:3757-68. [DOI: 10.1007/s11033-012-2452-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
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The Potential for Risk Stratification in the Management of Ovarian Cancer Risk. Int J Gynecol Cancer 2012; 22 Suppl 1:S16-7. [DOI: 10.1097/igc.0b013e318251caaf] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Ghoussaini M, Fletcher O, Michailidou K, Turnbull C, Schmidt MK, Dicks E, Dennis J, Wang Q, Humphreys MK, Luccarini C, Baynes C, Conroy D, Maranian M, Ahmed S, Driver K, Johnson N, Orr N, dos Santos Silva I, Waisfisz Q, Meijers-Heijboer H, Uitterlinden AG, Rivadeneira F, Hall P, Czene K, Irwanto A, Liu J, Nevanlinna H, Aittomäki K, Blomqvist C, Meindl A, Schmutzler RK, Müller-Myhsok B, Lichtner P, Chang-Claude J, Hein R, Nickels S, Flesch-Janys D, Tsimiklis H, Makalic E, Schmidt D, Bui M, Hopper JL, Apicella C, Park DJ, Southey M, Hunter DJ, Chanock SJ, Broeks A, Verhoef S, Hogervorst FBL, Fasching PA, Lux MP, Beckmann MW, Ekici AB, Sawyer E, Tomlinson I, Kerin M, Marme F, Schneeweiss A, Sohn C, Burwinkel B, Guénel P, Truong T, Cordina-Duverger E, Menegaux F, Bojesen SE, Nordestgaard BG, Nielsen SF, Flyger H, Milne RL, Alonso MR, González-Neira A, Benítez J, Anton-Culver H, Ziogas A, Bernstein L, Dur CC, Brenner H, Müller H, Arndt V, Stegmaier C, Justenhoven C, Brauch H, Brüning T, Wang-Gohrke S, Eilber U, Dörk T, Schürmann P, Bremer M, Hillemanns P, Bogdanova NV, Antonenkova NN, Rogov YI, Karstens JH, Bermisheva M, Prokofieva D, Khusnutdinova E, Lindblom A, Margolin S, Mannermaa A, Kataja V, Kosma VM, Hartikainen JM, Lambrechts D, Yesilyurt BT, Floris G, Leunen K, Manoukian S, Bonanni B, Fortuzzi S, Peterlongo P, Couch FJ, Wang X, Stevens K, Lee A, Giles GG, Baglietto L, Severi G, McLean C, Alnaes GG, Kristensen V, Børrensen-Dale AL, John EM, Miron A, Winqvist R, Pylkäs K, Jukkola-Vuorinen A, Kauppila S, Andrulis IL, Glendon G, Mulligan AM, Devilee P, van Asperen CJ, Tollenaar RAEM, Seynaeve C, Figueroa JD, Garcia-Closas M, Brinton L, Lissowska J, Hooning MJ, Hollestelle A, Oldenburg RA, van den Ouweland AMW, Cox A, Reed MWR, Shah M, Jakubowska A, Lubinski J, Jaworska K, Durda K, Jones M, Schoemaker M, Ashworth A, Swerdlow A, Beesley J, Chen X, Muir KR, Lophatananon A, Rattanamongkongul S, Chaiwerawattana A, Kang D, Yoo KY, Noh DY, Shen CY, Yu JC, Wu PE, Hsiung CN, Perkins A, Swann R, Velentzis L, Eccles DM, Tapper WJ, Gerty SM, Graham NJ, Ponder BAJ, Chenevix-Trench G, Pharoah PDP, Lathrop M, Dunning AM, Rahman N, Peto J, Easton DF. Genome-wide association analysis identifies three new breast cancer susceptibility loci. Nat Genet 2012; 44:312-8. [PMID: 22267197 PMCID: PMC3653403 DOI: 10.1038/ng.1049] [Citation(s) in RCA: 216] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 12/01/2011] [Indexed: 12/14/2022]
Abstract
Breast cancer is the most common cancer among women. To date, 22 common breast cancer susceptibility loci have been identified accounting for ∼8% of the heritability of the disease. We attempted to replicate 72 promising associations from two independent genome-wide association studies (GWAS) in ∼70,000 cases and ∼68,000 controls from 41 case-control studies and 9 breast cancer GWAS. We identified three new breast cancer risk loci at 12p11 (rs10771399; P = 2.7 × 10(-35)), 12q24 (rs1292011; P = 4.3 × 10(-19)) and 21q21 (rs2823093; P = 1.1 × 10(-12)). rs10771399 was associated with similar relative risks for both estrogen receptor (ER)-negative and ER-positive breast cancer, whereas the other two loci were associated only with ER-positive disease. Two of the loci lie in regions that contain strong plausible candidate genes: PTHLH (12p11) has a crucial role in mammary gland development and the establishment of bone metastasis in breast cancer, and NRIP1 (21q21) encodes an ER cofactor and has a role in the regulation of breast cancer cell growth.
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Affiliation(s)
- Maya Ghoussaini
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, UK
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Macinnis RJ, Antoniou AC, Eeles RA, Severi G, Al Olama AA, McGuffog L, Kote-Jarai Z, Guy M, O'Brien LT, Hall AL, Wilkinson RA, Sawyer E, Ardern-Jones AT, Dearnaley DP, Horwich A, Khoo VS, Parker CC, Huddart RA, Van As N, McCredie MR, English DR, Giles GG, Hopper JL, Easton DF. A risk prediction algorithm based on family history and common genetic variants: application to prostate cancer with potential clinical impact. Genet Epidemiol 2011; 35:549-56. [PMID: 21769933 DOI: 10.1002/gepi.20605] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 05/03/2011] [Accepted: 05/31/2011] [Indexed: 01/07/2023]
Abstract
Genome wide association studies have identified several single nucleotide polymorphisms (SNPs) that are independently associated with small increments in risk of prostate cancer, opening up the possibility for using such variants in risk prediction. Using segregation analysis of population-based samples of 4,390 families of prostate cancer patients from the UK and Australia, and assuming all familial aggregation has genetic causes, we previously found that the best model for the genetic susceptibility to prostate cancer was a mixed model of inheritance that included both a recessive major gene component and a polygenic component (P) that represents the effect of a large number of genetic variants each of small effect, where . Based on published studies of 26 SNPs that are currently known to be associated with prostate cancer, we have extended our model to incorporate these SNPs by decomposing the polygenic component into two parts: a polygenic component due to the known susceptibility SNPs, , and the residual polygenic component due to the postulated but as yet unknown genetic variants, . The resulting algorithm can be used for predicting the probability of developing prostate cancer in the future based on both SNP profiles and explicit family history information. This approach can be applied to other diseases for which population-based family data and established risk variants exist.
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Affiliation(s)
- Robert J Macinnis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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Pearce CL, Doherty JA, Van Den Berg DJ, Moysich K, Hsu C, Cushing-Haugen KL, Conti DV, Ramus SJ, Gentry-Maharaj A, Menon U, Gayther SA, Pharoah PDP, Song H, Kjaer SK, Hogdall E, Hogdall C, Whittemore AS, McGuire V, Sieh W, Gronwald J, Medrek K, Jakubowska A, Lubinski J, Chenevix-Trench G, Beesley J, Webb PM, Berchuck A, Schildkraut JM, Iversen ES, Moorman PG, Edlund CK, Stram DO, Pike MC, Ness RB, Rossing MA, Wu AH. Genetic variation in insulin-like growth factor 2 may play a role in ovarian cancer risk. Hum Mol Genet 2011; 20:2263-72. [PMID: 21422097 PMCID: PMC3090188 DOI: 10.1093/hmg/ddr087] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 02/17/2011] [Accepted: 02/23/2011] [Indexed: 01/20/2023] Open
Abstract
The insulin-like growth factor (IGF) signaling axis plays an important role in cancer biology. We hypothesized that genetic variation in this pathway may influence risk of ovarian cancer. A three-center study of non-Hispanic whites including 1880 control women, 1135 women with invasive epithelial ovarian cancer and 321 women with borderline epithelial ovarian tumors was carried out to test the association between tag single-nucleotide polymorphisms (tSNPs) (n=58) in this pathway and risk of ovarian cancer. We found no association between variation in IGF1, IGFBP1 or IGFBP3 and risk of invasive disease, whereas five tSNPs in IGF2 were associated with risk of invasive epithelial ovarian cancer at P<0.05 and followed-up one of the associated SNPs. We conducted genotyping in 3216 additional non-Hispanic white cases and 5382 additional controls and were able to independently replicate our initial findings. In the combined set of studies, rs4320932 was associated with a 13% decreased risk of ovarian cancer per copy of the minor allele carried (95% confidence interval 0.81-0.93, P-trend=7.4 × 10(-5)). No heterogeneity of effect across study centers was observed (p(het)=0.25). IGF2 is emerging as an important gene for ovarian cancer; additional genotyping is warranted to further confirm these associations with IGF2 and to narrow down the region harboring the causal SNP.
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Affiliation(s)
- Celeste Leigh Pearce
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA.
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Gadzicki D, Evans DG, Harris H, Julian-Reynier C, Nippert I, Schmidtke J, Tibben A, van Asperen CJ, Schlegelberger B. Genetic testing for familial/hereditary breast cancer-comparison of guidelines and recommendations from the UK, France, the Netherlands and Germany. J Community Genet 2011; 2:53-69. [PMID: 22109790 PMCID: PMC3186026 DOI: 10.1007/s12687-011-0042-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 02/09/2011] [Indexed: 12/19/2022] Open
Abstract
In this review, the national guidelines and recommendations for genetic testing for familial/hereditary breast cancer from the UK, France, the Netherlands and Germany were evaluated as to the inclusion criteria for genetic testing. In all four countries, access to genetic testing relies basically on the family history of breast and ovarian cancer. Similarities are obvious for most selection criteria. All four guidelines recommend embedding genetic testing within a framework of genetic counselling, and all agree to perform genetic testing first in an affected person. However, there are differences regarding the thresholds based on certain familial constellations, detailed description of selection criteria, the degree of relatedness between affected individuals and the counsellee, the age of diagnosis, the individual history of early onset breast cancer, bilateral breast cancer, the tumour morphology or the access to intensified surveillance. These differences and open questions not covered by the guidelines, e.g. on how to deal with phenocopies, unclassified variants, genetic variants in newly identified breast cancer susceptibility genes or with family constellations not fitting the criteria, are discussed. New evidence is usually slowly integrated into the guidelines. An exchange process towards the harmonization of the guidelines will ensure high quality health care across Europe.
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Affiliation(s)
- Dorothea Gadzicki
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany,
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Multicenter surveillance of women at high genetic breast cancer risk using mammography, ultrasonography, and contrast-enhanced magnetic resonance imaging (the high breast cancer risk italian 1 study): final results. Invest Radiol 2011; 46:94-105. [PMID: 21139507 DOI: 10.1097/rli.0b013e3181f3fcdf] [Citation(s) in RCA: 231] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES : To prospectively compare clinical breast examination, mammography, ultrasonography, and contrast-enhanced magnetic resonance imaging (MRI) in a multicenter surveillance of high-risk women. MATERIALS AND METHODS : We enrolled asymptomatic women aged ≥ 25: BRCA mutation carriers; first-degree relatives of BRCA mutation carriers, and women with strong family history of breast/ovarian cancer, including those with previous personal breast cancer. RESULTS : A total of 18 centers enrolled 501 women and performed 1592 rounds (3.2 rounds/woman). Forty-nine screen-detected and 3 interval cancers were diagnosed: 44 invasive, 8 ductal carcinoma in situ; only 4 pT2 stage; 32 G3 grade. Of 39 patients explored for nodal status, 28 (72%) were negative. Incidence per year-woman resulted 3.3% overall, 2.1% <50, and 5.4% ≥ 50 years (P < 0.001), 4.3% in women with previous personal breast cancer and 2.5% in those without (P = 0.045). MRI was more sensitive (91%) than clinical breast examination (18%), mammography (50%), ultrasonography (52%), or mammography plus ultrasonography (63%) (P < 0.001). Specificity ranged 96% to 99%, positive predictive value 53% to 71%, positive likelihood ratio 24 to 52 (P not significant). MRI showed significantly better negative predictive value (99.6) and negative likelihood ratio (0.09) than those of the other modalities. At receiver operating characteristic analysis, the area under the curve of MRI (0.97) was significantly higher than that of mammography (0.83) or ultrasonography (0.82) and not significantly increased when MRI was combined with mammography and/or ultrasonography. Of 52 cancers, 16 (31%) were diagnosed only by MRI, 8 of 21 (38%) in women <50, and 8 of 31 (26%) in women ≥ 50 years of age. CONCLUSION : MRI largely outperformed mammography, ultrasonography, and their combination for screening high-risk women below and over 50.
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Notaridou M, Quaye L, Dafou D, Jones C, Song H, Høgdall E, Kjaer SK, Christensen L, Høgdall C, Blaakaer J, McGuire V, Wu AH, Van Den Berg DJ, Pike MC, Gentry-Maharaj A, Wozniak E, Sher T, Jacobs IJ, Tyrer J, Schildkraut JM, Moorman PG, Iversen ES, Jakubowska A, Mędrek K, Lubiński J, Ness RB, Moysich KB, Lurie G, Wilkens LR, Carney ME, Wang-Gohrke S, Doherty JA, Rossing MA, Beckmann MW, Thiel FC, Ekici AB, Chen X, Beesley J, Gronwald J, Fasching PA, Chang-Claude J, Goodman MT, Chenevix-Trench G, Berchuck A, Pearce CL, Whittemore AS, Menon U, Pharoah PD, Gayther SA, Ramus SJ. Common alleles in candidate susceptibility genes associated with risk and development of epithelial ovarian cancer. Int J Cancer 2011; 128:2063-74. [PMID: 20635389 PMCID: PMC3098608 DOI: 10.1002/ijc.25554] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 05/26/2010] [Accepted: 06/24/2010] [Indexed: 12/26/2022]
Abstract
Common germline genetic variation in the population is associated with susceptibility to epithelial ovarian cancer. Microcell-mediated chromosome transfer and expression microarray analysis identified nine genes associated with functional suppression of tumorogenicity in ovarian cancer cell lines; AIFM2, AKTIP, AXIN2, CASP5, FILIP1L, RBBP8, RGC32, RUVBL1 and STAG3. Sixty-three tagging single nucleotide polymorphisms (tSNPs) in these genes were genotyped in 1,799 invasive ovarian cancer cases and 3,045 controls to look for associations with disease risk. Two SNPs in RUVBL1, rs13063604 and rs7650365, were associated with increased risk of serous ovarian cancer [HetOR = 1.42 (1.15-1.74) and the HomOR = 1.63 (1.10-1.42), p-trend = 0.0002] and [HetOR = 0.97 (0.80-1.17), HomOR = 0.74 (0.58-0.93), p-trend = 0.009], respectively. We genotyped rs13063604 and rs7650365 in an additional 4,590 cases and 6,031 controls from ten sites from the United States, Europe and Australia; however, neither SNP was significant in Stage 2. We also evaluated the potential role of tSNPs in these nine genes in ovarian cancer development by testing for allele-specific loss of heterozygosity (LOH) in 286 primary ovarian tumours. We found frequent LOH for tSNPs in AXIN2, AKTIP and RGC32 (64, 46 and 34%, respectively) and one SNP, rs1637001, in STAG3 showed significant allele-specific LOH with loss of the common allele in 94% of informative tumours (p = 0.015). Array comparative genomic hybridisation indicated that this nonrandom allelic imbalance was due to amplification of the rare allele. In conclusion, we show evidence for the involvement of a common allele of STAG3 in the development of epithelial ovarian cancer.
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Affiliation(s)
- Maria Notaridou
- Gynaecological Oncology Unit, UCL EGA Institute for Women’s Health, University College London, United Kingdom
| | - Lydia Quaye
- Gynaecological Oncology Unit, UCL EGA Institute for Women’s Health, University College London, United Kingdom
| | - Dimitra Dafou
- Department of Medical and Molecular Genetics, King’s College London School of Medicine, Guy’s Hospital, London, United Kingdom
| | - Chris Jones
- Gynaecological Oncology Unit, UCL EGA Institute for Women’s Health, University College London, United Kingdom
| | - Honglin Song
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Estrid Høgdall
- Department of Viruses, Hormones and Cancer, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Susanne K. Kjaer
- Department of Viruses, Hormones and Cancer, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Lise Christensen
- Department of Pathology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Claus Høgdall
- The Gynaecologic Clinic, The Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Denmark
| | - Jan Blaakaer
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Skejby, Aarhus, Denmark
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA
| | - Anna H. Wu
- University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA
| | - David J. Van Den Berg
- University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA
| | - Malcolm C. Pike
- University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA
| | - Aleksandra Gentry-Maharaj
- Gynaecological Oncology Unit, UCL EGA Institute for Women’s Health, University College London, United Kingdom
| | - Eva Wozniak
- Gynaecological Oncology Unit, UCL EGA Institute for Women’s Health, University College London, United Kingdom
| | - Tanya Sher
- Gynaecological Oncology Unit, UCL EGA Institute for Women’s Health, University College London, United Kingdom
| | - Ian J. Jacobs
- Gynaecological Oncology Unit, UCL EGA Institute for Women’s Health, University College London, United Kingdom
| | - Jonathan Tyrer
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | | | - Patricia G. Moorman
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC
| | - Edwin S. Iversen
- Department of Statistical Science, Duke University, Medical Center, Durham, NC
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Mędrek
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | | | - Kirsten B. Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY
| | - Galina Lurie
- Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI
| | - Lynne R. Wilkens
- Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI
| | - Michael E. Carney
- Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI
| | - Shan Wang-Gohrke
- Department of Obstetrics and Gynecology, University of Ulm, Ulm, Germany
| | - Jennifer A. Doherty
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
| | - Falk C. Thiel
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
| | - Arif B. Ekici
- Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Xiaoqing Chen
- Genetics and Population Health, The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
| | - Jonathan Beesley
- Genetics and Population Health, The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
| | | | - Jacek Gronwald
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
- Division of Hematology and Oncology, University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, CA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Marc T. Goodman
- Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI
| | - Georgia Chenevix-Trench
- Genetics and Population Health, The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology/Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC, 27710
| | - C. Leigh Pearce
- University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA
| | - Alice S. Whittemore
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA
| | - Usha Menon
- Gynaecological Oncology Unit, UCL EGA Institute for Women’s Health, University College London, United Kingdom
| | - Paul D.P. Pharoah
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Simon A. Gayther
- Gynaecological Oncology Unit, UCL EGA Institute for Women’s Health, University College London, United Kingdom
| | - Susan J. Ramus
- Gynaecological Oncology Unit, UCL EGA Institute for Women’s Health, University College London, United Kingdom
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Abstract
Recent candidate gene and genome wide association studies have revealed novel loci associated with an increased risk of breast cancer. We evaluated the effect of these breast cancer associated variants on ovarian cancer risk in individuals with familial ovarian cancer both with and without BRCA1 or BRCA2 mutations. A total of 158 unrelated white British women (54 BRCA1/2 mutation positive and 104 BRCA1/2 mutation negative) with familial ovarian cancer were genotyped for FGFR2, TNRC9/TOX3 and CASP8 variants. The p.Asp302His CASP8 variant was associated with reduced ovarian cancer risk in the familial BRCA1/2 mutation negative ovarian cancer cases (P = 0.016). The synonymous TNRC9/TOX3 (Ser51) variant was present at a significantly lower frequency than in patients with familial BRCA1/2 positive breast cancer (P = 0.0002). Our results indicate that variants in CASP8 and TNRC9/TOX3 alter the risk of disease in individuals affected with familial ovarian cancer.
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White KL, Rider DN, Kalli KR, Knutson KL, Jarvik GP, Goode EL. Genomics of the NF-κB signaling pathway: hypothesized role in ovarian cancer. Cancer Causes Control 2011; 22:785-801. [PMID: 21359843 DOI: 10.1007/s10552-011-9745-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 02/09/2011] [Indexed: 12/17/2022]
Abstract
OBJECTIVE We sought to review evidence linking nuclear factor-kappa B (NF-κB) to ovarian cancer and to identify genetic variants involved in NF-κB signaling. METHODS PubMed was reviewed to inform on ovarian cancer biology and NF-κB signaling and to identify key genes. Public linkage disequilibrium (LD) data were analyzed to identify informative inherited variants (tagSNPs) using ldSelect. RESULTS We identified 319 key NF-κB genes including five NF-κB subunits, 167 activating genes, and 55 inhibiting genes. We found that the 1000 Genomes Project was the most informative LD source for most genes (92.8%), and we identified 13,027 LD bins (r (2) ≥ 0.9, minor allele frequency ≥ 0.05) and 1,018 putative-functional variants worthy of investigation. We also report that reliance on a commonly used genome-wide SNP array and genotype imputation with HapMap Phase II data provides data on only 74% of the common inherited NF-κB SNPs of interest. CONCLUSIONS Compelling evidence suggests that NF-κB plays a critical role in ovarian cancer, yet inherited variation in these genes has not been thoroughly assessed in relation to disease risk or outcome. We present a collection of variants in key genes and suggest creation of a custom genotyping array as an optimal approach.
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Affiliation(s)
- Kristin L White
- Department of Health Sciences Research, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA
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Comprehensive BRCA1 and BRCA2 mutation analyses and review of French Canadian families with at least three cases of breast cancer. Fam Cancer 2010; 9:507-17. [DOI: 10.1007/s10689-010-9372-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Ratner E, Lu L, Boeke M, Barnett R, Nallur S, Chin LJ, Pelletier C, Blitzblau R, Tassi R, Paranjape T, Hui P, Godwin AK, Yu H, Risch H, Rutherford T, Schwartz P, Santin A, Matloff E, Zelterman D, Slack FJ, Weidhaas JB. A KRAS-variant in ovarian cancer acts as a genetic marker of cancer risk. Cancer Res 2010; 70:6509-15. [PMID: 20647319 DOI: 10.1158/0008-5472.can-10-0689] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Ovarian cancer (OC) is the single most deadly form of women's cancer, typically presenting as an advanced disease at diagnosis in part due to a lack of known risk factors or genetic markers of risk. The KRAS oncogene and altered levels of the microRNA (miRNA) let-7 are associated with an increased risk of developing solid tumors. In this study, we investigated a hypothesized association between an increased risk of OC and a variant allele of KRAS at rs61764370, referred to as the KRAS-variant, which disrupts a let-7 miRNA binding site in this oncogene. Specimens obtained were tested for the presence of the KRAS-variant from nonselected OC patients in three independent cohorts, two independent ovarian case-control studies, and OC patients with hereditary breast and ovarian cancer syndrome (HBOC) as well as their family members. Our results indicate that the KRAS-variant is associated with more than 25% of nonselected OC cases. Further, we found that it is a marker for a significant increased risk of developing OC, as confirmed by two independent case-control analyses. Lastly, we determined that the KRAS-variant was present in 61% of HBOC patients without BRCA1 or BRCA2 mutations, previously considered uninformative, as well as in their family members with cancer. Our findings strongly support the hypothesis that the KRAS-variant is a genetic marker for increased risk of developing OC, and they suggest that the KRAS-variant may be a new genetic marker of cancer risk for HBOC families without other known genetic abnormalities.
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Affiliation(s)
- Elena Ratner
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06520, USA
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Mavaddat N, Rebbeck TR, Lakhani SR, Easton DF, Antoniou AC. Incorporating tumour pathology information into breast cancer risk prediction algorithms. Breast Cancer Res 2010; 12:R28. [PMID: 20482762 PMCID: PMC2917017 DOI: 10.1186/bcr2576] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 05/04/2010] [Accepted: 05/18/2010] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Mutations in BRCA1 and BRCA2 confer high risks of breast cancer and ovarian cancer. The risk prediction algorithm BOADICEA (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm) may be used to compute the probabilities of carrying mutations in BRCA1 and BRCA2 and help to target mutation screening. Tumours from BRCA1 and BRCA2 mutation carriers display distinctive pathological features that could be used to better discriminate between BRCA1 mutation carriers, BRCA2 mutation carriers and noncarriers. In particular, oestrogen receptor (ER)-negative status, triple-negative (TN) status, and expression of basal markers are predictive of BRCA1 mutation carrier status. METHODS We extended BOADICEA by treating breast cancer subtypes as distinct disease end points. Age-specific expression of phenotypic markers in a series of tumours from 182 BRCA1 mutation carriers, 62 BRCA2 mutation carriers and 109 controls from the Breast Cancer Linkage Consortium, and over 300,000 tumours from the general population obtained from the Surveillance Epidemiology, and End Results database, were used to calculate age-specific and genotype-specific incidences of each disease end point. The probability that an individual carries a BRCA1 or BRCA2 mutation given their family history and tumour marker status of family members was computed in sample pedigrees. RESULTS The cumulative risk of ER-negative breast cancer by age 70 for BRCA1 mutation carriers was estimated to be 55% and the risk of ER-positive disease was 18%. The corresponding risks for BRCA2 mutation carriers were 21% and 44% for ER-negative and ER-positive disease, respectively. The predicted BRCA1 carrier probabilities among ER-positive breast cancer cases were less than 1% at all ages. For women diagnosed with breast cancer below age 50 years, these probabilities rose to more than 5% in ER-negative breast cancer, 7% in TN disease and 24% in TN breast cancer expressing both CK5/6 and CK14 cytokeratins. Large differences in mutation probabilities were observed by combining ER status and other informative markers with family history. CONCLUSIONS This approach combines both full pedigree and tumour subtype data to predict BRCA1/2 carrier probabilities. Prediction of BRCA1/2 carrier status, and hence selection of women for mutation screening, may be substantially improved by combining tumour pathology with family history of cancer.
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Affiliation(s)
- Nasim Mavaddat
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
| | - Timothy R Rebbeck
- Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania, 217 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Sunil R Lakhani
- Molecular and Cellular Pathology, University of Queensland Centre for Clinical Research, Level 6 Building 71/918, University of Queensland, The Royal Brisbane & Women's Hospital, Herston, 4029 Brisbane, Queensland, Australia
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
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Amir E, Freedman OC, Seruga B, Evans DG. Assessing women at high risk of breast cancer: a review of risk assessment models. J Natl Cancer Inst 2010; 102:680-91. [PMID: 20427433 DOI: 10.1093/jnci/djq088] [Citation(s) in RCA: 311] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Women who are at high risk of breast cancer can be offered more intensive surveillance or prophylactic measures, such as surgery or chemoprevention. Central to decisions regarding the level of prevention is accurate and individualized risk assessment. This review aims to distill the diverse literature and provide practicing clinicians with an overview of the available risk assessment methods. Risk assessments fall into two groups: the risk of carrying a mutation in a high-risk gene such as BRCA1 or BRCA2 and the risk of developing breast cancer with or without such a mutation. Knowledge of breast cancer risks, taken together with the risks and benefits of the intervention, is needed to choose an appropriate disease management strategy. A number of models have been developed for assessing these risks, but independent validation of such models has produced variable results. Some models are able to predict both mutation carriage risks and breast cancer risk; however, to date, all are limited by only moderate discriminatory accuracy. Further improvements in the knowledge of how to best integrate both new risk factors and newly discovered genetic variants into these models will allow clinicians to more accurately determine which women are most likely to develop breast cancer. These steady and incremental improvements in models will need to undergo revalidation.
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Affiliation(s)
- Eitan Amir
- Division of Medical Oncology and Hematology, Princess Margaret Hospital, 610 University Ave, Toronto, ON M5G2M9, Canada.
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Gayther SA, Pharoah PDP. The inherited genetics of ovarian and endometrial cancer. Curr Opin Genet Dev 2010; 20:231-8. [PMID: 20456938 DOI: 10.1016/j.gde.2010.03.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 02/28/2010] [Accepted: 03/02/2010] [Indexed: 12/31/2022]
Abstract
Endometrial and epithelial ovarian cancers are the fourth and fifth most common cancers in women in developed countries, after breast, lung, and colorectal cancer. In the United States alone, in 2008 there were about 40,000 new diagnoses of endometrial cancer and 7500 disease-related deaths. For ovarian cancer, there were about 22,000 new diagnoses and 15,000 deaths over the same period. The purpose of this article is to review the recent developments in the inherited genetics of ovarian and endometrial cancer, with particular attention to recent progress in identifying common low-penetrance susceptibility genes and their clinical implications.
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Affiliation(s)
- Simon A Gayther
- EGA Institute for Women's Health, Gynaecological Cancer Research Laboratories, University College London, London, UK.
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Yarden RI, Friedman E, Metsuyanim S, Olender T, Ben-Asher E, Papa MZ. Single-nucleotide polymorphisms in the p53 pathway genes modify cancer risk in BRCA1 and BRCA2 carriers of Jewish-Ashkenazi descent. Mol Carcinog 2010; 49:545-55. [DOI: 10.1002/mc.20618] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Ready K, Litton JK, Arun BK. Clinical application of breast cancer risk assessment models. Future Oncol 2010; 6:355-65. [DOI: 10.2217/fon.10.5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
With the evolving availability of testing for genetic cancer syndromes, oncologists now are increasingly expected to review family histories and to give a genetic risk assessment as part of their care for breast cancer. The most important of these breast cancer genetic syndromes identified to date have been those associated with the BRCA1 and BRCA2 genes. Therefore, the proper identification of potentially affected families and providing risk assessment estimates will be ever more essential. This review outlines several different available breast cancer risk assessment models. Risk models for the development of breast cancer as well as risk models that estimate the chance of having a genetic cancer syndrome are discussed. Their clinical applications are also outlined and clinical situations appropriate for each model are reviewed.
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Affiliation(s)
- Kaylene Ready
- The Univeristy of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX 77030, USA
| | - Jennifer K Litton
- The Univeristy of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX 77030, USA
| | - Banu K Arun
- The Univeristy of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX 77030, USA
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Kuhl C, Weigel S, Schrading S, Arand B, Bieling H, König R, Tombach B, Leutner C, Rieber-Brambs A, Nordhoff D, Heindel W, Reiser M, Schild HH. Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA trial. J Clin Oncol 2010; 28:1450-7. [PMID: 20177029 DOI: 10.1200/jco.2009.23.0839] [Citation(s) in RCA: 344] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE We investigated the respective contribution (in terms of cancer yield and stage at diagnosis) of clinical breast examination (CBE), mammography, ultrasound, and quality-assured breast magnetic resonance imaging (MRI), used alone or in different combination, for screening women at elevated risk for breast cancer. METHODS Prospective multicenter observational cohort study. Six hundred eighty-seven asymptomatic women at elevated familial risk (> or = 20% lifetime) underwent 1,679 annual screening rounds consisting of CBE, mammography, ultrasound, and MRI, read independently and in different combinations. In a subgroup of 371 women, additional half-yearly ultrasound and CBE was performed more than 869 screening rounds. Mean and median follow-up was 29.18 and 29.09 months. RESULTS Twenty-seven women were diagnosed with breast cancer: 11 ductal carcinoma in situ (41%) and 16 invasive cancers (59%). Three (11%) of 27 were node positive. All cancers were detected during annual screening; no interval cancer occurred; no cancer was identified during half-yearly ultrasound. The cancer yield of ultrasound (6.0 of 1,000) and mammography (5.4 of 1,000) was equivalent; it increased nonsignificantly (7.7 of 1,000) if both methods were combined. Cancer yield achieved by MRI alone (14.9 of 1,000) was significantly higher; it was not significantly improved by adding mammography (MRI plus mammography: 16.0 of 1,000) and did not change by adding ultrasound (MRI plus ultrasound: 14.9 of 1,000). Positive predictive value was 39% for mammography, 36% for ultrasound, and 48% for MRI. CONCLUSION In women at elevated familial risk, quality-assured MRI screening shifts the distribution of screen-detected breast cancers toward the preinvasive stage. In women undergoing quality-assured MRI annually, neither mammography, nor annual or half-yearly ultrasound or CBE will add to the cancer yield achieved by MRI alone.
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Affiliation(s)
- Christiane Kuhl
- Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, D-53105 Bonn, Germany.
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Evaluation of a breast/ovarian cancer genetics referral screening tool in a mammography population. Genet Med 2009; 11:783-9. [DOI: 10.1097/gim.0b013e3181b9b04a] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Song H, Ramus SJ, Tyrer J, Bolton KL, Gentry-Maharaj A, Wozniak E, Anton-Culver H, Chang-Claude J, Cramer DW, DiCioccio R, Dörk T, Goode EL, Goodman MT, Schildkraut JM, Sellers T, Baglietto L, Beckmann MW, Beesley J, Blaakaer J, Carney ME, Chanock S, Chen Z, Cunningham JM, Dicks E, Doherty JA, Dürst M, Ekici AB, Fenstermacher D, Fridley BL, Giles G, Gore ME, De Vivo I, Hillemanns P, Hogdall C, Hogdall E, Iversen ES, Jacobs IJ, Jakubowska A, Li D, Lissowska J, Lubiński J, Lurie G, McGuire V, McLaughlin J, Mędrek K, Moorman PG, Moysich K, Narod S, Phelan C, Pye C, Risch H, Runnebaum IB, Severi G, Southey M, Stram DO, Thiel FC, Terry KL, Tsai YY, Tworoger SS, Van Den Berg DJ, Vierkant RA, Wang-Gohrke S, Webb PM, Wilkens LR, Wu AH, Yang H, Brewster W, Ziogas A, Houlston R, Tomlinson I, Whittemore AS, Rossing MA, Ponder BA, Pearce CL, Ness RB, Menon U, Kjaer SK, Gronwald J, Garcia-Closas M, Fasching PA, Easton DF, Chenevix-Trench G, Berchuck A, Pharoah PD, Gayther SA. A genome-wide association study identifies a new ovarian cancer susceptibility locus on 9p22.2. Nat Genet 2009; 41:996-1000. [PMID: 19648919 PMCID: PMC2844110 DOI: 10.1038/ng.424] [Citation(s) in RCA: 255] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Accepted: 07/02/2009] [Indexed: 12/11/2022]
Abstract
Epithelial ovarian cancer has a major heritable component, but the known susceptibility genes explain less than half the excess familial risk. We performed a genome-wide association study (GWAS) to identify common ovarian cancer susceptibility alleles. We evaluated 507,094 SNPs genotyped in 1,817 cases and 2,353 controls from the UK and approximately 2 million imputed SNPs. We genotyped the 22,790 top ranked SNPs in 4,274 cases and 4,809 controls of European ancestry from Europe, USA and Australia. We identified 12 SNPs at 9p22 associated with disease risk (P < 10(-8)). The most significant SNP (rs3814113; P = 2.5 x 10(-17)) was genotyped in a further 2,670 ovarian cancer cases and 4,668 controls, confirming its association (combined data odds ratio (OR) = 0.82, 95% confidence interval (CI) 0.79-0.86, P(trend) = 5.1 x 10(-19)). The association differs by histological subtype, being strongest for serous ovarian cancers (OR 0.77, 95% CI 0.73-0.81, P(trend) = 4.1 x 10(-21)).
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Affiliation(s)
- Honglin Song
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Susan J. Ramus
- Department of Gynaecological Oncology, UCL EGA Institute for Women’s Health, University College London, UK
| | - Jonathan Tyrer
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Kelly L. Bolton
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Aleksandra Gentry-Maharaj
- Department of Gynaecological Oncology, UCL EGA Institute for Women’s Health, University College London, UK
| | - Eva Wozniak
- Department of Gynaecological Oncology, UCL EGA Institute for Women’s Health, University College London, UK
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Daniel W. Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Boston, MA
| | - Richard DiCioccio
- Department of Cancer Genetics and the Gilda Radner Familial Ovarian Cancer Registry Buffalo, NY, USA
| | - Thilo Dörk
- Clinics of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
| | | | - Marc T Goodman
- Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, USA
| | | | - Thomas Sellers
- Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, USA
| | - Laura Baglietto
- Cancer Epidemiology Centre, The Cancer Council Victoria, Rathdowne Street, Carlton VIC 3053, Australia
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Swanston Street, Carlton VIC 3053, Australia
| | | | - Jonathan Beesley
- The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
| | - Jan Blaakaer
- Department of Gynaecological and Obstetrics, Skejby University Hospital, Arhus
| | - Michael E Carney
- Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, USA
| | - Stephen Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Zhihua Chen
- Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, USA
| | | | - Ed Dicks
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jennifer A. Doherty
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Matthias Dürst
- Department of Gynaecology and Obstetrics, University Hospital of Jena, Germany
| | - Arif B. Ekici
- Institute of Human Genetics, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | | | | | - Graham Giles
- Cancer Epidemiology Centre, The Cancer Council Victoria, Rathdowne Street, Carlton VIC 3053, Australia
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Swanston Street, Carlton VIC 3053, Australia
| | - Martin E. Gore
- The Royal Marsden Hospital, Gynecological Oncology Unit, London, UK
| | - Immaculata De Vivo
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital & Harvard Medical School, Boston, MA
| | - Peter Hillemanns
- Clinics of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
| | - Claus Hogdall
- The Gyneacologic Clinic, The Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Estrid Hogdall
- Department of Viruses, Hormones and Cancer, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | | | - Ian J Jacobs
- Department of Gynaecological Oncology, UCL EGA Institute for Women’s Health, University College London, UK
| | - Anna Jakubowska
- International Hereditary Cancer Center, Department Of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Dong Li
- Department of Epidemiology, University of California Irvine, USA
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Cancer Centre and Institute of Oncology, Warsaw, Poland
| | - Jan Lubiński
- International Hereditary Cancer Center, Department Of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Galina Lurie
- Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, USA
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, USA
| | - John McLaughlin
- Samuel Lunenfeld Research Institute, 60 Murray Street, Toronto, ON, Canada
| | - Krzysztof Mędrek
- International Hereditary Cancer Center, Department Of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Patricia G. Moorman
- The Comprehensive Cancer Center, Duke University Medical Center, Durham, NC, USA
| | | | - Steven Narod
- Center for Research in Women’s Health, 790 Bay St., Toronto, ON, Canada
| | | | - Carole Pye
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Harvey Risch
- Yale University, 60 College Street, New Haven, CT, USA
| | - Ingo B Runnebaum
- Department of Gynaecology and Obstetrics, University Hospital of Jena, Germany
| | - Gianluca Severi
- Cancer Epidemiology Centre, The Cancer Council Victoria, Rathdowne Street, Carlton VIC 3053, Australia
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Swanston Street, Carlton VIC 3053, Australia
| | - Melissa Southey
- Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, VIC 3010, Australia
| | - Daniel O. Stram
- University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Falk C. Thiel
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Germany
| | - Kathryn L. Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Boston, MA
| | - Ya-Yu Tsai
- Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, USA
| | - Shelley S. Tworoger
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital & Harvard Medical School, Boston, MA
| | - David J. Van Den Berg
- University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | | | - Shan Wang-Gohrke
- Department of Obstetrics and Gynaecology, University of Ulm, Ulm, Germany
| | - Penelope M. Webb
- The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
| | - Lynne R. Wilkens
- Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, USA
| | - Anna H Wu
- University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Hannah Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Wendy Brewster
- Department of Obstetrics and Gynecology, University North Carolina, Chapel Hill, North Carolina, USA
| | - Argyrios Ziogas
- Department of Epidemiology, University of California Irvine, USA
| | | | | | | | - Richard Houlston
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, UK
| | - Ian Tomlinson
- Population and Functional Genetics Lab, Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - Alice S Whittemore
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, USA
| | - Mary Anne Rossing
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Bruce A.J. Ponder
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Celeste Leigh Pearce
- University of Southern California, Keck School of Medicine, Los Angeles, California, USA
| | - Roberta B. Ness
- The University of Texas, School of Public Health, Houston, TX, USA
| | - Usha Menon
- Department of Gynaecological Oncology, UCL EGA Institute for Women’s Health, University College London, UK
| | - Susanne Krüger Kjaer
- Department of Viruses, Hormones and Cancer, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department Of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Montserrat Garcia-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Peter A. Fasching
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Germany
- University of California at Los Angeles, David Geffen School of Medicine, Division of Hematology and Oncology
| | - Douglas F Easton
- CR-UK Genetic Epidemiology Unit, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Georgia Chenevix-Trench
- The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
| | - Andrew Berchuck
- The Comprehensive Cancer Center, Duke University Medical Center, Durham, NC, USA
| | - Paul D.P. Pharoah
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Simon A. Gayther
- Department of Gynaecological Oncology, UCL EGA Institute for Women’s Health, University College London, UK
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Association between common germline genetic variation in 94 candidate genes or regions and risks of invasive epithelial ovarian cancer. PLoS One 2009; 4:e5983. [PMID: 19543528 PMCID: PMC2695002 DOI: 10.1371/journal.pone.0005983] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Accepted: 05/08/2009] [Indexed: 12/16/2022] Open
Abstract
Background Recent studies have identified several single nucleotide polymorphisms (SNPs) in the population that are associated with variations in the risks of many different diseases including cancers such as breast, prostate and colorectal. For ovarian cancer, the known highly penetrant susceptibility genes (BRCA1 and BRCA2) are probably responsible for only 40% of the excess familial ovarian cancer risks, suggesting that other susceptibility genes of lower penetrance exist. Methods We have taken a candidate approach to identifying moderate risk susceptibility alleles for ovarian cancer. To date, we have genotyped 340 SNPs from 94 candidate genes or regions, in up to 1,491 invasive epithelial ovarian cancer cases and 3,145 unaffected controls from three different population based studies from the UK, Denmark and USA. Results After adjusting for population stratification by genomic control, 18 SNPs (5.3%) were significant at the 5% level, and 5 SNPs (1.5%) were significant at the 1% level. The most significant association was for the SNP rs2107425, located on chromosome 11p15.5, which has previously been identified as a susceptibility allele for breast cancer from a genome wide association study (P-trend = 0.0012). When SNPs/genes were stratified into 7 different pathways or groups of validation SNPs, the breast cancer associated SNPs were the only group of SNPs that were significantly associated with ovarian cancer risk (P-heterogeneity = 0.0003; P-trend = 0.0028; adjusted (for population stratification) P-trend = 0.006). We did not find statistically significant associations when the combined data for all SNPs were analysed using an admixture maximum likelihood (AML) experiment-wise test for association (P-heterogeneity = 0.051; P-trend = 0.068). Conclusion These data suggest that a proportion of the SNPs we evaluated were associated with ovarian cancer risk, but that the effect sizes were too small to detect associations with individual SNPs.
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46
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White KL, Vierkant RA, Phelan CM, Fridley BL, Anderson S, Knutson KL, Schildkraut JM, Cunningham JM, Kelemen LE, Pankratz VS, Rider DN, Liebow M, Hartmann LC, Sellers TA, Goode EL. Polymorphisms in NF-kappaB inhibitors and risk of epithelial ovarian cancer. BMC Cancer 2009; 9:170. [PMID: 19500386 PMCID: PMC2706256 DOI: 10.1186/1471-2407-9-170] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Accepted: 06/06/2009] [Indexed: 01/07/2023] Open
Abstract
Background The nuclear factor-κB (NF-κB) family is a set of transcription factors with key roles in the induction of the inflammatory response and may be the link between inflammation and cancer development. This pathway has been shown to influence ovarian epithelial tissue repair. Inhibitors of κB (IκB) prevent NF-κB activation by sequestering NF-κB proteins in the cytoplasm until IκB proteins are phosphorylated and degraded. Methods We used a case-control study to evaluate the association between single nucleotide polymorphisms (SNPs) in NFKBIA and NFKBIB (the genes encoding IκBα and IκBβ, respectively) and risk of epithelial ovarian cancer. We queried 19 tagSNPs and putative-functional SNPs among 930 epithelial ovarian cancer cases and 1,037 controls from two studies. Results The minor allele for one synonymous SNP in NFKBIA, rs1957106, was associated with decreased risk (p = 0.03). Conclusion Considering the number of single-SNP tests performed and null gene-level results, we conclude that NFKBIA and NFKBIB are not likely to harbor ovarian cancer risk alleles. Due to its biological significance in ovarian cancer, additional genes encoding NF-κB subunits, activating and inhibiting molecules, and signaling molecules warrant interrogation.
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47
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Quaye L, Song H, Ramus SJ, Gentry-Maharaj A, Høgdall E, DiCioccio RA, McGuire V, Wu AH, Van Den Berg DJ, Pike MC, Wozniak E, Doherty JA, Rossing MA, Ness RB, Moysich KB, Høgdall C, Blaakaer J, Easton DF, Ponder BAJ, Jacobs IJ, Menon U, Whittemore AS, Krüger-Kjaer S, Pearce CL, Pharoah PDP, Gayther SA. Tagging single-nucleotide polymorphisms in candidate oncogenes and susceptibility to ovarian cancer. Br J Cancer 2009; 100:993-1001. [PMID: 19240718 PMCID: PMC2661781 DOI: 10.1038/sj.bjc.6604947] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 01/19/2009] [Accepted: 01/26/2009] [Indexed: 01/02/2023] Open
Abstract
Low-moderate risk alleles that are relatively common in the population may explain a significant proportion of the excess familial risk of ovarian cancer (OC) not attributed to highly penetrant genes. In this study, we evaluated the risks of OC associated with common germline variants in five oncogenes (BRAF, ERBB2, KRAS, NMI and PIK3CA) known to be involved in OC development. Thirty-four tagging SNPs in these genes were genotyped in approximately 1800 invasive OC cases and 3000 controls from population-based studies in Denmark, the United Kingdom and the United States. We found no evidence of disease association for SNPs in BRAF, KRAS, ERBB2 and PIK3CA when OC was considered as a single disease phenotype; but after stratification by histological subtype, we found borderline evidence of association for SNPs in KRAS and BRAF with mucinous OC and in ERBB2 and PIK3CA with endometrioid OC. For NMI, we identified a SNP (rs11683487) that was associated with a decreased risk of OC (unadjusted P(dominant)=0.004). We then genotyped rs11683487 in another 1097 cases and 1792 controls from an additional three case-control studies from the United States. The combined odds ratio was 0.89 (95% confidence interval (CI): 0.80-0.99) and remained statistically significant (P(dominant)=0.032). We also identified two haplotypes in ERBB2 associated with an increased OC risk (P(global)=0.034) and a haplotype in BRAF that had a protective effect (P(global)=0.005). In conclusion, these data provide borderline evidence of association for common allelic variation in the NMI with risk of epithelial OC.
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Affiliation(s)
- L Quaye
- Gynaecological Oncology Department, UCL EGA Institute for Women's Health, University College London, London, UK
| | - H Song
- Strangeways Research Laboratory, CR-UK Department of Oncology, University of Cambridge, Cambridge, UK
| | - S J Ramus
- Gynaecological Oncology Department, UCL EGA Institute for Women's Health, University College London, London, UK
| | - A Gentry-Maharaj
- Gynaecological Oncology Department, UCL EGA Institute for Women's Health, University College London, London, UK
| | - E Høgdall
- Department of Virus, Hormones and Cancer, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - R A DiCioccio
- Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - V McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - A H Wu
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - D J Van Den Berg
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - M C Pike
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - E Wozniak
- Gynaecological Oncology Department, UCL EGA Institute for Women's Health, University College London, London, UK
| | - J A Doherty
- JD Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - M A Rossing
- JD Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - R B Ness
- Department of Epidemiology and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - K B Moysich
- Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - C Høgdall
- Gynaecology Clinic, The Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Denmark, CR-UK
| | - J Blaakaer
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Skejby, Aarhus, Denmark
| | - The Ovarian Cancer Association Consortium
- Gynaecological Oncology Department, UCL EGA Institute for Women's Health, University College London, London, UK
- Strangeways Research Laboratory, CR-UK Department of Oncology, University of Cambridge, Cambridge, UK
- Department of Virus, Hormones and Cancer, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
- Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, NY, USA
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
- JD Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
- Gynaecology Clinic, The Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Denmark, CR-UK
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Skejby, Aarhus, Denmark
- Department of Oncology, Strangeways Research Laboratory, Genetic Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - D F Easton
- Department of Oncology, Strangeways Research Laboratory, Genetic Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - B A J Ponder
- Strangeways Research Laboratory, CR-UK Department of Oncology, University of Cambridge, Cambridge, UK
| | - I J Jacobs
- Gynaecological Oncology Department, UCL EGA Institute for Women's Health, University College London, London, UK
| | - U Menon
- Gynaecological Oncology Department, UCL EGA Institute for Women's Health, University College London, London, UK
| | - A S Whittemore
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - S Krüger-Kjaer
- Department of Virus, Hormones and Cancer, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
- Gynaecology Clinic, The Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Denmark, CR-UK
| | - C L Pearce
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - P D P Pharoah
- Strangeways Research Laboratory, CR-UK Department of Oncology, University of Cambridge, Cambridge, UK
| | - S A Gayther
- Gynaecological Oncology Department, UCL EGA Institute for Women's Health, University College London, London, UK
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Garofalo JP, Soliday E, Cole B, Dawson E, Henderson BN. Impact of a Breast Cancer Diagnosis on Adult Children's Cognitive and Emotional Coherence. J Psychosoc Oncol 2009; 27:25-41. [DOI: 10.1080/07347330802614659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pearce CL, Near AM, Van Den Berg DJ, Ramus SJ, Gentry-Maharaj A, Menon U, Gayther SA, Anderson AR, Edlund CK, Wu AH, Chen X, Beesley J, Webb PM, Holt SK, Chen C, Doherty JA, Rossing MA, Whittemore AS, McGuire V, DiCioccio RA, Goodman MT, Lurie G, Carney ME, Wilkens LR, Ness RB, Moysich KB, Edwards R, Jennison E, Kjaer SK, Hogdall E, Hogdall CK, Goode EL, Sellers TA, Vierkant RA, Cunningham JM, Cunningham JC, Schildkraut JM, Berchuck A, Moorman PG, Iversen ES, Cramer DW, Terry KL, Vitonis AF, Titus-Ernstoff L, Song H, Pharoah PDP, Spurdle AB, Anton-Culver H, Ziogas A, Brewster W, Galitovskiy V, Chenevix-Trench G. Validating genetic risk associations for ovarian cancer through the international Ovarian Cancer Association Consortium. Br J Cancer 2009; 100:412-20. [PMID: 19127255 PMCID: PMC2634713 DOI: 10.1038/sj.bjc.6604820] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Revised: 11/11/2008] [Accepted: 11/18/2008] [Indexed: 12/12/2022] Open
Abstract
The search for genetic variants associated with ovarian cancer risk has focused on pathways including sex steroid hormones, DNA repair, and cell cycle control. The Ovarian Cancer Association Consortium (OCAC) identified 10 single-nucleotide polymorphisms (SNPs) in genes in these pathways, which had been genotyped by Consortium members and a pooled analysis of these data was conducted. Three of the 10 SNPs showed evidence of an association with ovarian cancer at P< or =0.10 in a log-additive model: rs2740574 in CYP3A4 (P=0.011), rs1805386 in LIG4 (P=0.007), and rs3218536 in XRCC2 (P=0.095). Additional genotyping in other OCAC studies was undertaken and only the variant in CYP3A4, rs2740574, continued to show an association in the replication data among homozygous carriers: OR(homozygous(hom))=2.50 (95% CI 0.54-11.57, P=0.24) with 1406 cases and 2827 controls. Overall, in the combined data the odds ratio was 2.81 among carriers of two copies of the minor allele (95% CI 1.20-6.56, P=0.017, p(het) across studies=0.42) with 1969 cases and 3491 controls. There was no association among heterozygous carriers. CYP3A4 encodes a key enzyme in oestrogen metabolism and our finding between rs2740574 and risk of ovarian cancer suggests that this pathway may be involved in ovarian carcinogenesis. Additional follow-up is warranted.
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Affiliation(s)
- C L Pearce
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
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50
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Ramus SJ, Vierkant RA, Johnatty SE, Pike MC, Van Den Berg DJ, Wu AH, Pearce CL, Menon U, Gentry-Maharaj A, Gayther SA, DiCioccio RA, McGuire V, Whittemore AS, Song H, Easton DF, Pharoah PDP, Garcia-Closas M, Chanock S, Lissowska J, Brinton L, Terry KL, Cramer DW, Tworoger SS, Hankinson SE, Berchuck A, Moorman PG, Schildkraut JM, Cunningham JM, Liebow M, Kjaer SK, Hogdall E, Hogdall C, Blaakaer J, Ness RB, Moysich KB, Edwards RP, Carney ME, Lurie G, Goodman MT, Wang-Gohrke S, Kropp S, Chang-Claude J, Webb PM, Chen X, Beesley J, Chenevix-Trench G, Goode EL. Consortium analysis of 7 candidate SNPs for ovarian cancer. Int J Cancer 2008; 123:380-388. [PMID: 18431743 DOI: 10.1002/ijc.23448] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Ovarian Cancer Association Consortium selected 7 candidate single nucleotide polymorphisms (SNPs), for which there is evidence from previous studies of an association with variation in ovarian cancer or breast cancer risks. The SNPs selected for analysis were F31I (rs2273535) in AURKA, N372H (rs144848) in BRCA2, rs2854344 in intron 17 of RB1, rs2811712 5' flanking CDKN2A, rs523349 in the 3' UTR of SRD5A2, D302H (rs1045485) in CASP8 and L10P (rs1982073) in TGFB1. Fourteen studies genotyped 4,624 invasive epithelial ovarian cancer cases and 8,113 controls of white non-Hispanic origin. A marginally significant association was found for RB1 when all studies were included [ordinal odds ratio (OR) 0.88 (95% confidence interval (CI) 0.79-1.00) p = 0.041 and dominant OR 0.87 (95% CI 0.76-0.98) p = 0.025]; when the studies that originally suggested an association were excluded, the result was suggestive although no longer statistically significant (ordinal OR 0.92, 95% CI 0.79-1.06). This SNP has also been shown to have an association with decreased risk in breast cancer. There was a suggestion of an association for AURKA, when one study that caused significant study heterogeneity was excluded [ordinal OR 1.10 (95% CI 1.01-1.20) p = 0.027; dominant OR 1.12 (95% CI 1.01-1.24) p = 0.03]. The other 5 SNPs in BRCA2, CDKN2A, SRD5A2, CASP8 and TGFB1 showed no association with ovarian cancer risk; given the large sample size, these results can also be considered to be informative. These null results for SNPs identified from relatively large initial studies shows the importance of replicating associations by a consortium approach.
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Affiliation(s)
- Susan J Ramus
- Translational Research Laboratory, University College London EGA Institute for Women's Health, London, United Kingdom
| | | | - Sharon E Johnatty
- The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
| | - Malcolm C Pike
- University of Southern California, Keck School of Medicine, Los Angeles, CA
| | | | - Anna H Wu
- University of Southern California, Keck School of Medicine, Los Angeles, CA
| | | | - Usha Menon
- Gynaecological Cancer Research Centre, University College London, EGA Institute for Women's Health, London, United Kingdom
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, University College London, EGA Institute for Women's Health, London, United Kingdom
| | - Simon A Gayther
- Translational Research Laboratory, University College London EGA Institute for Women's Health, London, United Kingdom
| | | | | | | | - Honglin Song
- Cancer Research United Kingdom Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Douglas F Easton
- Cancer Research United Kingdom Genetic Epidemiology Unit, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Paul D P Pharoah
- Cancer Research United Kingdom Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | | | - Stephen Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, Cancer Center and M. Sklodowska-Curie Institute of Oncology, Warsaw, Poland
| | - Louise Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Kathryn L Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA
| | - Daniel W Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA
| | - Shelley S Tworoger
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Susan E Hankinson
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC
| | - Patricia G Moorman
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC
| | - Joellen M Schildkraut
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC
| | | | - Mark Liebow
- College of Medicine, Mayo Clinic, Rochester, MN
| | | | | | - Claus Hogdall
- Rigshospitalet, The Juliane Marie Centre, University of Copenhagen, Copenhagen, Denmark
| | | | - Roberta B Ness
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | | | | | | | - Galina Lurie
- Cancer Research Center, University of Hawaii, Honolulu, Hawaii
| | - Marc T Goodman
- Cancer Research Center, University of Hawaii, Honolulu, Hawaii
| | | | - Silke Kropp
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Penelope M Webb
- The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
| | - Xiaoqing Chen
- The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
| | - Jonathan Beesley
- The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
| | - Georgia Chenevix-Trench
- The Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia
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