Phenotypic differences in juvenile polyposis syndrome with or without a disease-causing SMAD4/BMPR1A variant Journal Article


Authors: MacFarland, S. P.; Ebrahimzadeh, J. E.; Zelley, K.; Begum, L.; Bass, L. M.; Brand, R. E.; Dudley, B.; Fishman, D. S.; Ganzak, A.; Karloski, E.; Latham, A.; Llor, X.; Plon, S.; Riordan, M. K.; Scollon, S. R.; Stadler, Z. K.; Syngal, S.; Ukaegbu, C.; Weiss, J. M.; Yurgelun, M. B.; Brodeur, G. M.; Mamula, P.; Katona, B. W.
Article Title: Phenotypic differences in juvenile polyposis syndrome with or without a disease-causing SMAD4/BMPR1A variant
Abstract: Juvenile polyposis syndrome (JPS) is a clinically diagnosed hamartomatous polyposis syndrome that increases the risk of gastrointestinal cancer. Approximately 40%-50% of JPS is caused by a germline disease-causing variant (DCV) in the SMAD4 or BMPR1A genes. The aim of this study was to characterize the phenotype of DCV-negative JPS and compare it with DCV-positive JPS. Herein, we analyzed a cohort of 145 individuals with JPS from nine institutions, including both pediatric and adult centers. Data analyzed included age at diagnosis, family history, cancer history, need for colectomy/ gastrectomy, and polyp number and location. Compared with DCV-positive JPS, DCV-negative JPS was associated with younger age at diagnosis (P < 0.001), lower likelihood of having a family history of JPS (P < 0.001), and a lower risk of colectomy (P=0.032). None of the DCV-negative individuals had gastric or duodenal polyps, and polyp burden decreased after the first decade compared with DCV-positive JPS. Subgroup analysis between SMAD4 and BMPR1A carriers showed that SMAD4 carriers were more likely to have a family history of JPS and required gastrectomy. Taken together, these data provide the largest phenotypic characterization of individuals with DCVnegative JPS to date, showing that this group has distinct differences compared with JPS due to a SMAD4 or BMPR1A variant. Better understanding of phenotype and cancer risk associated with JPS both with and without a DCV may ultimately allow for individualized management of polyposis and cancer risk. © 2020 American Association for Cancer Research.
Journal Title: Cancer Prevention Research
Volume: 14
Issue: 2
ISSN: 1940-6207
Publisher: American Association for Cancer Research  
Date Published: 2021-02-01
Start Page: 215
End Page: 222
Language: English
DOI: 10.1158/1940-6207.Capr-20-0348
PROVIDER: scopus
PUBMED: 33097490
PMCID: PMC8557953
DOI/URL:
Notes: Article -- Export Date: 1 March 2021 -- Source: Scopus
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  1. Zsofia Kinga Stadler
    390 Stadler
  2. Alicia Latham
    58 Latham