TY - JOUR
T1 - Risks of primary extracolonic cancers following colorectal cancer in lynch syndrome
AU - Win, Aung Ko
AU - Lindor, Noralane M.
AU - Young, Joanne P.
AU - MacRae, Finlay A.
AU - Young, Graeme P.
AU - Williamson, Elizabeth
AU - Parry, Susan
AU - Goldblatt, Jack
AU - Lipton, Lara
AU - Winship, Ingrid
AU - Leggett, Barbara
AU - Tucker, Katherine M.
AU - Giles, Graham G.
AU - Buchanan, Daniel D.
AU - Clendenning, Mark
AU - Rosty, Christophe
AU - Arnold, Julie
AU - Joan Levine, A.
AU - Haile, Robert W.
AU - Gallinger, Steven
AU - Marchand, Loïc Le
AU - Newcomb, Polly A.
AU - Hopper, John L.
AU - Jenkins, Mark A.
N1 - Funding Information:
National Cancer Institute, National Institutes of Health under RFA #CA-95-011, and through cooperative agreements with members of the Colon Cancer Family Registry and Principal Investigators. AKW is supported by the Picchi Brothers Foundation Cancer Council Victoria Cancer Research Scholarship, Australia. JLH is a National Health and Medical Research Council Australia Fellow. MAJ is a National Health and Medical Research Council Senior Research Fellow. JPY is a Cancer Council Queensland Senior Research Fellow. CR is a Jass Pathology Fellow.
PY - 2012/9/19
Y1 - 2012/9/19
N2 - Background Lynch syndrome is a highly penetrant cancer predisposition syndrome caused by germline mutations in DNA mismatch repair (MMR) genes. We estimated the risks of primary cancers other than colorectal cancer following a diagnosis of colorectal cancer in mutation carriers.MethodsWe obtained data from the Colon Cancer Family Registry for 764 carriers of an MMR gene mutation (316 MLH1, 357 MSH2, 49 MSH6, and 42 PMS2), who had a previous diagnosis of colorectal cancer. The KaplanMeier method was used to estimate their cumulative risk of cancers 10 and 20 years after colorectal cancer. We estimated the age-, sex-, country-and calendar periodspecific standardized incidence ratios (SIRs) of cancers following colorectal cancer, compared with the general population.ResultsFollowing colorectal cancer, carriers of MMR gene mutations had the following 10-year risk of cancers in other organs: kidney, renal pelvis, ureter, and bladder (2%, 95% confidence interval [CI] = 1% to 3%); small intestine, stomach, and hepatobiliary tract (1%, 95% CI = 0.2% to 2%); prostate (3%, 95% CI = 1% to 5%); endometrium (12%, 95% CI = 8% to 17%); breast (2%, 95% CI = 1% to 4%); and ovary (1%, 95% CI = 0% to 2%). They were at elevated risk compared with the general population: cancers of the kidney, renal pelvis, and ureter (SIR = 12.54, 95% CI = 7.97 to 17.94), urinary bladder (SIR = 7.22, 95% CI = 4.08 to 10.99), small intestine (SIR = 72.68, 95% CI = 39.95 to 111.29), stomach (SIR = 5.65, 95% CI = 2.32 to 9.69), and hepatobiliary tract (SIR = 5.94, 95% CI = 1.81 to 10.94) for both sexes; cancer of the prostate (SIR = 2.05, 95% CI = 1.23 to 3.01), endometrium (SIR = 40.23, 95% CI = 27.91 to 56.06), breast (SIR = 1.76, 95% CI = 1.07 to 2.59), and ovary (SIR = 4.19, 95% CI = 1.28 to 7.97).ConclusionCarriers of MMR gene mutations who have already had a colorectal cancer are at increased risk of a greater range of cancers than the recognized spectrum of Lynch syndrome cancers, including breast and prostate cancers.
AB - Background Lynch syndrome is a highly penetrant cancer predisposition syndrome caused by germline mutations in DNA mismatch repair (MMR) genes. We estimated the risks of primary cancers other than colorectal cancer following a diagnosis of colorectal cancer in mutation carriers.MethodsWe obtained data from the Colon Cancer Family Registry for 764 carriers of an MMR gene mutation (316 MLH1, 357 MSH2, 49 MSH6, and 42 PMS2), who had a previous diagnosis of colorectal cancer. The KaplanMeier method was used to estimate their cumulative risk of cancers 10 and 20 years after colorectal cancer. We estimated the age-, sex-, country-and calendar periodspecific standardized incidence ratios (SIRs) of cancers following colorectal cancer, compared with the general population.ResultsFollowing colorectal cancer, carriers of MMR gene mutations had the following 10-year risk of cancers in other organs: kidney, renal pelvis, ureter, and bladder (2%, 95% confidence interval [CI] = 1% to 3%); small intestine, stomach, and hepatobiliary tract (1%, 95% CI = 0.2% to 2%); prostate (3%, 95% CI = 1% to 5%); endometrium (12%, 95% CI = 8% to 17%); breast (2%, 95% CI = 1% to 4%); and ovary (1%, 95% CI = 0% to 2%). They were at elevated risk compared with the general population: cancers of the kidney, renal pelvis, and ureter (SIR = 12.54, 95% CI = 7.97 to 17.94), urinary bladder (SIR = 7.22, 95% CI = 4.08 to 10.99), small intestine (SIR = 72.68, 95% CI = 39.95 to 111.29), stomach (SIR = 5.65, 95% CI = 2.32 to 9.69), and hepatobiliary tract (SIR = 5.94, 95% CI = 1.81 to 10.94) for both sexes; cancer of the prostate (SIR = 2.05, 95% CI = 1.23 to 3.01), endometrium (SIR = 40.23, 95% CI = 27.91 to 56.06), breast (SIR = 1.76, 95% CI = 1.07 to 2.59), and ovary (SIR = 4.19, 95% CI = 1.28 to 7.97).ConclusionCarriers of MMR gene mutations who have already had a colorectal cancer are at increased risk of a greater range of cancers than the recognized spectrum of Lynch syndrome cancers, including breast and prostate cancers.
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U2 - 10.1093/jnci/djs351
DO - 10.1093/jnci/djs351
M3 - Article
C2 - 22933731
AN - SCOPUS:84866658167
SN - 0027-8874
VL - 104
SP - 1363
EP - 1372
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 18
ER -