[HTML][HTML] Rare disruptive mutations and their contribution to the heritable risk of colorectal cancer

D Chubb, P Broderick, SE Dobbins, M Frampton… - Nature …, 2016 - nature.com
D Chubb, P Broderick, SE Dobbins, M Frampton, B Kinnersley, S Penegar, A Price, YP Ma…
Nature communications, 2016nature.com
Colorectal cancer (CRC) displays a complex pattern of inheritance. It is postulated that much
of the missing heritability of CRC is enshrined in high-impact rare alleles, which are
mechanistically and clinically important. In this study, we assay the impact of rare germline
mutations on CRC, analysing high-coverage exome sequencing data on 1,006 early-onset
familial CRC cases and 1,609 healthy controls, with additional sequencing and array data
on up to 5,552 cases and 6,792 controls. We identify highly penetrant rare mutations in 16 …
Abstract
Colorectal cancer (CRC) displays a complex pattern of inheritance. It is postulated that much of the missing heritability of CRC is enshrined in high-impact rare alleles, which are mechanistically and clinically important. In this study, we assay the impact of rare germline mutations on CRC, analysing high-coverage exome sequencing data on 1,006 early-onset familial CRC cases and 1,609 healthy controls, with additional sequencing and array data on up to 5,552 cases and 6,792 controls. We identify highly penetrant rare mutations in 16% of familial CRC. Although the majority of these reside in known genes, we identify POT1, POLE2 and MRE11 as candidate CRC genes. We did not identify any coding low-frequency alleles (1–5%) with moderate effect. Our study clarifies the genetic architecture of CRC and probably discounts the existence of further major high-penetrance susceptibility genes, which individually account for >1% of the familial risk. Our results inform future study design and provide a resource for contextualizing the impact of new CRC genes.
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