Cumulative burden of colorectal cancer–associated genetic variants is more strongly associated with early-onset vs late-onset cancer Journal Article


Authors: Archambault, A. N.; Su, Y. R.; Jeon, J.; Thomas, M.; Lin, Y.; Conti, D. V.; Win, A. K.; Sakoda, L. C.; Lansdorp-Vogelaar, I.; Peterse, E. F. P.; Zauber, A. G.; Duggan, D.; Holowatyj, A. N.; Huyghe, J. R.; Brenner, H.; Cotterchio, M.; Bézieau, S.; Schmit, S. L.; Edlund, C. K.; Southey, M. C.; MacInnis, R. J.; Campbell, P. T.; Chang-Claude, J.; Slattery, M. L.; Chan, A. T.; Joshi, A. D.; Song, M.; Cao, Y.; Woods, M. O.; White, E.; Weinstein, S. J.; Ulrich, C. M.; Hoffmeister, M.; Bien, S. A.; Harrison, T. A.; Hampe, J.; Li, C. I.; Schafmayer, C.; Offit, K.; Pharoah, P. D.; Moreno, V.; Lindblom, A.; Wolk, A.; Wu, A. H.; Li, L.; Gunter, M. J.; Gsur, A.; Keku, T. O.; Pearlman, R.; Bishop, D. T.; Castellví-Bel, S.; Moreira, L.; Vodicka, P.; Kampman, E.; Giles, G. G.; Albanes, D.; Baron, J. A.; Berndt, S. I.; Brezina, S.; Buch, S.; Buchanan, D. D.; Trichopoulou, A.; Severi, G.; Chirlaque, M. D.; Sánchez, M. J.; Palli, D.; Kühn, T.; Murphy, N.; Cross, A. J.; Burnett-Hartman, A. N.; Chanock, S. J.; de la Chapelle, A.; Easton, D. F.; Elliott, F.; English, D. R.; Feskens, E. J. M.; FitzGerald, L. M.; Goodman, P. J.; Hopper, J. L.; Hudson, T. J.; Hunter, D. J.; Jacobs, E. J.; Joshu, C. E.; Küry, S.; Markowitz, S. D.; Milne, R. L.; Platz, E. A.; Rennert, G.; Rennert, H. S.; Schumacher, F. R.; Sandler, R. S.; Seminara, D.; Tangen, C. M.; Thibodeau, S. N.; Toland, A. E.; van Duijnhoven, F. J. B.; Visvanathan, K.; Vodickova, L.; Potter, J. D.; Männistö, S.; Weigl, K.; Figueiredo, J.; Martín, V.; Larsson, S. C.; Parfrey, P. S.; Huang, W. Y.; Lenz, H. J.; Castelao, J. E.; Gago-Dominguez, M.; Muñoz-Garzón, V.; Mancao, C.; Haiman, C. A.; Wilkens, L. R.; Siegel, E.; Barry, E.; Younghusband, B.; Van Guelpen, B.; Harlid, S.; Zeleniuch-Jacquotte, A.; Liang, P. S.; Du, M.; Casey, G.; Lindor, N. M.; Le Marchand, L.; Gallinger, S. J.; Jenkins, M. A.; Newcomb, P. A.; Gruber, S. B.; Schoen, R. E.; Hampel, H.; Corley, D. A.; Hsu, L.; Peters, U.; Hayes, R. B.
Article Title: Cumulative burden of colorectal cancer–associated genetic variants is more strongly associated with early-onset vs late-onset cancer
Abstract: Background & Aims: Early-onset colorectal cancer (CRC, in persons younger than 50 years old) is increasing in incidence; yet, in the absence of a family history of CRC, this population lacks harmonized recommendations for prevention. We aimed to determine whether a polygenic risk score (PRS) developed from 95 CRC-associated common genetic risk variants was associated with risk for early-onset CRC. Methods: We studied risk for CRC associated with a weighted PRS in 12,197 participants younger than 50 years old vs 95,865 participants 50 years or older. PRS was calculated based on single nucleotide polymorphisms associated with CRC in a large-scale genome-wide association study as of January 2019. Participants were pooled from 3 large consortia that provided clinical and genotyping data: the Colon Cancer Family Registry, the Colorectal Transdisciplinary Study, and the Genetics and Epidemiology of Colorectal Cancer Consortium and were all of genetically defined European descent. Findings were replicated in an independent cohort of 72,573 participants. Results: Overall associations with CRC per standard deviation of PRS were significant for early-onset cancer, and were stronger compared with late-onset cancer (P for interaction = .01); when we compared the highest PRS quartile with the lowest, risk increased 3.7-fold for early-onset CRC (95% CI 3.28–4.24) vs 2.9-fold for late-onset CRC (95% CI 2.80–3.04). This association was strongest for participants without a first-degree family history of CRC (P for interaction = 5.61 × 10–5). When we compared the highest with the lowest quartiles in this group, risk increased 4.3-fold for early-onset CRC (95% CI 3.61–5.01) vs 2.9-fold for late-onset CRC (95% CI 2.70–3.00). Sensitivity analyses were consistent with these findings. Conclusions: In an analysis of associations with CRC per standard deviation of PRS, we found the cumulative burden of CRC-associated common genetic variants to associate with early-onset cancer, and to be more strongly associated with early-onset than late-onset cancer, particularly in the absence of CRC family history. Analyses of PRS, along with environmental and lifestyle risk factors, might identify younger individuals who would benefit from preventive measures. © 2020 AGA Institute
Keywords: adolescent; adult; controlled study; aged; major clinical study; single nucleotide polymorphism; cancer risk; follow up; colorectal cancer; cohort analysis; genetic association; genetic variability; genotype; gene frequency; genome-wide association study; colon cancer; family history; epithelial cell adhesion molecule; genetic risk; protein msh6; mismatch repair protein pms2; penetrance; hereditary nonpolyposis colorectal cancer; snp; human; male; female; priority journal; article; mutl protein homolog 1; dna mismatch repair protein msh2; genetic risk score; eocrc
Journal Title: Gastroenterology
Volume: 158
Issue: 5
ISSN: 0016-5085
Publisher: Elsevier Inc.  
Date Published: 2020-04-01
Start Page: 1274
End Page: 1286.e12
Language: English
DOI: 10.1053/j.gastro.2019.12.012
PUBMED: 31866242
PROVIDER: scopus
PMCID: PMC7103489
DOI/URL:
Notes: Article -- Export Date: 1 April 2020 -- Source: Scopus
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  1. Kenneth Offit
    765 Offit
  2. Ann G Zauber
    300 Zauber
  3. Mengmeng   Du
    69 Du