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Cancer spectrum in DNA mismatch repair gene mutation carriers: results from a hospital based Lynch syndrome registry

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Abstract

The spectrum of cancers seen in a hospital based Lynch syndrome registry of mismatch repair gene mutation carriers was examined to determine the distribution of cancers and examine excess cancer risk. Overall there were 504 cancers recorded in 368 mutation carriers from 176 families. These included 236 (46.8 %) colorectal and 268 (53.2 %) extracolonic cancers. MLH1 mutation carriers had a higher frequency of colorectal cancers whereas MSH2, MSH6 and PMS2 mutation carriers had more extracolonic cancers although these differences were not statistically significant. Men had fewer extracolonic cancers than colorectal (45.3 vs. 54.7 %), whereas women had more extracolonic than colorectal cancers (59.0 vs. 41.0 %). The mean age at diagnosis overall for extracolonic cancers was older than for colorectal, 49.1 versus 44.8 years (P ≤ 0.001). As expected, the index cancer was colorectal in 58.1 % of patients and among the extracolonic index cancers, endometrial was the most common (13.8 %). A significant number of non-Lynch syndrome index cancers were recorded including breast (n = 5) prostate (n = 3), thyroid (n = 3), cervix (n = 3), melanoma (n = 3), and 1 case each of thymoma, sinus cavity, and adenocarcinoma of the lung. However, standardized incidence ratios calculated to assess excess cancer risk showed that only those cancers known to be associated with Lynch syndrome were significant in our sample. We found that Lynch syndrome patients can often present with cancers that are not considered part of Lynch syndrome. This has clinical relevance both for diagnosis of Lynch syndrome and surveillance for cancers of different sites during follow-up of these patients.

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Acknowledgments

This research was supported in part by the National Institutes of Health through MD Anderson’s Cancer Center Support Grant (CA016672) which supports the Biospecimen and Extraction Resource and the Human Pedigree Analysis Resource service cores; and research grant 5R01CA070759-11.

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Authors and Affiliations

  1. Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Unit 1365, PO Box 301439, Houston, TX, 77230-1439, USA

    Mala Pande, Chongjuan Wei, Jinyun Chen, Laura A. Lucio & Marsha L. Frazier

  2. Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Christopher I. Amos

  3. Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Patrick M. Lynch & Maureen E. Mork

  4. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Karen H. Lu & Stephanie G. Boyd-Rogers

  5. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Sarah A. Bannon

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  1. Mala Pande
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  2. Chongjuan Wei
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Correspondence to Marsha L. Frazier.

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Pande, M., Wei, C., Chen, J. et al. Cancer spectrum in DNA mismatch repair gene mutation carriers: results from a hospital based Lynch syndrome registry. Familial Cancer 11, 441–447 (2012). https://doi.org/10.1007/s10689-012-9534-6

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  • DOI: https://doi.org/10.1007/s10689-012-9534-6

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