Lynch Syndrome Caused by Germline PMS2 Mutations: Delineating the Cancer Risk

Sanne W Ten Broeke, Richard M Brohet, Carli M Tops, Heleen M van der Klift, Mary E Velthuizen, Inge Bernstein, Gabriel Capellá Munar, Encarna Gomez Garcia, Nicoline Hoogerbrugge, Tom G W Letteboer, Fred H Menko, Annika Lindblom, Arjen R Mensenkamp, Pal Moller, Theo A van Os, Nils Rahner, Bert J W Redeker, Rolf H Sijmons, Liesbeth Spruijt, Manon SuerinkYvonne J Vos, Anja Wagner, Frederik J Hes, Hans F Vasen, Maartje Nielsen, Juul T Wijnen

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156 Citationer (Scopus)

Abstract

PURPOSE: The clinical consequences of PMS2 germline mutations are poorly understood compared with other Lynch-associated mismatch repair gene (MMR) mutations. The aim of this European cohort study was to define the cancer risk faced by PMS2 mutation carriers.

METHODS: Data were collected from 98 PMS2 families ascertained from family cancer clinics that included a total of 2,548 family members and 377 proven mutation carriers. To adjust for potential ascertainment bias, a modified segregation analysis model was used to calculate colorectal cancer (CRC) and endometrial cancer (EC) risks. Standardized incidence ratios (SIRs) were calculated to estimate risks for other Lynch syndrome-associated cancers.

RESULTS: The cumulative risk (CR) of CRC for male mutation carriers by age 70 years was 19%. The CR among female carriers was 11% for CRC and 12% for EC. The mean age of CRC development was 52 years, and there was a significant difference in mean age of CRC between the probands (mean, 47 years; range, 26 to 68 years) and other family members with a PMS2 mutation (mean, 58 years; range, 31 to 86 years; P < .001). Significant SIRs were observed for cancers of the small bowel, ovaries, breast, and renal pelvis.

CONCLUSION: CRC and EC risks were found to be markedly lower than those previously reported for the other MMR. However, these risks embody the isolated risk of carrying a PMS2 mutation, and it should be noted that we observed a substantial variation in cancer phenotype within and between families, suggesting the influence of genetic modifiers and lifestyle factors on cancer risks.

OriginalsprogEngelsk
TidsskriftJournal of Clinical Oncology
Vol/bind33
Udgave nummer4
Sider (fra-til)319-325
Antal sider7
ISSN0732-183X
DOI
StatusUdgivet - 2015

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