RT Journal Article
SR Electronic
T1 Universal germline testing among patients with colorectal cancer: clinical actionability and optimised panel
JF Journal of Medical Genetics
JO J Med Genet
FD BMJ Publishing Group Ltd
SP 370
OP 376
DO 10.1136/jmedgenet-2020-107230
VO 59
IS 4
A1 Wu Jiang
A1 Lin Li
A1 Chuan-Feng Ke
A1 Wei Wang
A1 Bin-Yi Xiao
A1 Ling-Heng Kong
A1 Jing-Hua Tang
A1 Yuan Li
A1 Xiao-Dan Wu
A1 Ying Hu
A1 Wei-Hua Guo
A1 Si-Zhen Wang
A1 De-Sen Wan
A1 Rui-Hua Xu
A1 Zhi-Zhong Pan
A1 Pei-Rong Ding
YR 2022
UL http://jmg.bmj.com/content/59/4/370.abstract
AB Purpose Universal germline testing in patients with colorectal cancer (CRC) with a multigene panel can detect various hereditary cancer syndromes. This study was performed to understand how to choose a testing panel and whether the result would affect clinical management.Methods We prospectively enrolled 486 eligible patients with CRC, including all patients with CRC diagnosed under age 70 years and patients with CRC diagnosed over 70 years with hereditary risk features between November 2017 and January 2018. All participants received germline testing for various hereditary cancer syndromes.Results The prevalence of germline pathogenic variants (PVs) in cancer susceptibility genes was 7.8% (38/486), including 25 PVs in genes with high-risk CRC susceptibility (the minimal testing set) and 13 PVs in genes with moderate-risk CRC susceptibility or increased cancer risk other than CRC (the additional testing set). All the clinically relevant PVs were found in patients diagnosed under age 70 years. Among them, 11 patients would not have been diagnosed if testing reserved to present guidelines. Most (36/38) of the patients with PVs benefited from enhanced surveillance and tailored treatment. PVs in genes from the minimal testing set were found in all age groups, while patients carried PVs in genes from the additional testing set were older than 40 years.Conclusion Universal germline testing for cancer susceptibility genes should be recommended among all patients with CRC diagnosed under age 70 years. A broad panel including genes from the additional testing set might be considered for patients with CRC older than 40 years to clarify inheritance risks.Trial registration number NCT03365986.Data are available in a public, open access repository. Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. All data have been recorded at Sun Yat-sen University Cancer Center for future reference (http://rdd.sysucc.org.cn/, RDDA2019001141).