Risk of Pancreatic Cancer Among Individuals With Pathogenic Variants in the ATM Gene
| Autor: | Erica J. Childs, Kari G. Rabe, Fang Chi Hsu, Nancy Porter, Nicholas J. Roberts, Ralph H. Hruban, George Zogopoulos, Chinedu Ukaegbu, Steven Gallinger, Alison P. Klein, Ayelet Borgida, Michael Goggins, Sapna Syngal, Gloria M. Petersen |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
Proband Adult Cancer Research medicine.medical_specialty Ataxia Telangiectasia Mutated Proteins Cohort Studies Pancreatic cancer Internal medicine medicine Humans Genetic Testing Germ-Line Mutation Genetic testing Aged Original Investigation Aged 80 and over medicine.diagnostic_test business.industry Middle Aged medicine.disease Penetrance Pedigree Pancreatic Neoplasms Relative risk Population study Observational study Female business Cohort study |
| Zdroj: | JAMA Oncol |
| ISSN: | 2374-2445 |
| Popis: | IMPORTANCE: Pathogenic germline variants in the ATM gene have been associated with pancreatic cancer risk. Although genetic testing identifies these variants in approximately 1% to 3% of unselected patients with pancreatic cancer, the lifetime risk of pancreatic cancer among individuals with pathogenic ATM variants has not been well estimated. OBJECTIVE: To estimate age-specific penetrance of pancreatic cancer in individuals with a pathogenic variant in the ATM gene. DESIGN, SETTING, AND PARTICIPANTS: This was a multicenter cohort study of pancreatic cancer family registries in the US and Canada using pedigree data from 130 pancreatic cancer kindreds with a pathogenic germline ATM variant. Data analyses were performed from January 2020 to February 2021. MAIN OUTCOMES AND MEASURES: Observational age-specific risk of pancreatic cancer. Penetrance was estimated using modified segregation analysis. RESULTS: The study population of 130 families (123 [95%] White families) comprised 2227 family members (mean age [SD], 58 [22] years; 1096 [49%] women) with complete records (ie, including familial relationships, pancreatic cancer diagnosis, ATM status, proband status, and age), of which 155 individuals had positive results for an ATM pathogenic variant, 16 had a negative result, and the remainder did not have a test result. In these 130 families, 217 individuals had pancreatic cancer: 78 families had 1 such member; 34 families had 2 such members; and 18 families had 3 or more members with pancreatic cancer. The average (range) age at diagnosis was 64 (31-98) years. The cumulative risk of pancreatic cancer among individuals with a germline pathogenic ATM variant was estimated to be 1.1% (95% CI, 0.8%-1.3%) by age 50 years; 6.3% (95% CI, 3.9%-8.7%) by age 70 years; and 9.5% (95% CI, 5.0%-14.0%) by age 80 years. Overall, the relative risk of pancreatic cancer was 6.5 (95% CI, 4.5-9.5) in ATM variant carriers compared with noncarriers. CONCLUSIONS AND RELEVANCE: This multicenter cohort study found that individuals with a germline pathogenic ATM variant were at an increased lifetime risk of pancreatic cancer. These risk estimates can help guide decision-making when evaluating the risks and benefits of enhanced early detection surveillance. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|