Honglin Song1, Ed Dicks1, Susan J Ramus1, Jonathan P Tyrer1, Maria P Intermaggio1, Jane Hayward1, Christopher K Edlund1, David Conti1, Patricia Harrington1, Lindsay Fraser1, Susan Philpott1, Christopher Anderson1, Adam Rosenthal1, Aleksandra Gentry-Maharaj1, David D Bowtell1, Kathryn Alsop1, Mine S Cicek1, Julie M Cunningham1, Brooke L Fridley1, Jennifer Alsop1, Mercedes Jimenez-Linan1, Estrid Høgdall1, Claus K Høgdall1, Allan Jensen1, Susanne Krüger Kjaer1, Jan Lubiński1, Tomasz Huzarski1, Anna Jakubowska1, Jacek Gronwald1, Samantha Poblete1, Shashi Lele1, Lara Sucheston-Campbell1, Kirsten B Moysich1, Kunle Odunsi1, Ellen L Goode1, Usha Menon1, Ian J Jacobs1, Simon A Gayther2, Paul D P Pharoah1. 1. Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY. 2. Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY. simon.gayther@med.usc.edu.
Abstract
PURPOSE: The aim of this study was to estimate the contribution of deleterious mutations in the RAD51B, RAD51C, and RAD51D genes to invasive epithelial ovarian cancer (EOC) in the population and in a screening trial of individuals at high risk of ovarian cancer. PATIENTS AND METHODS: The coding sequence and splice site boundaries of the three RAD51 genes were sequenced and analyzed in germline DNA from a case-control study of 3,429 patients with invasive EOC and 2,772 controls as well as in 2,000 unaffected women who were BRCA1/BRCA2 negative from the United Kingdom Familial Ovarian Cancer Screening Study (UK_FOCSS) after quality-control analysis. RESULTS: In the case-control study, we identified predicted deleterious mutations in 28 EOC cases (0.82%) compared with three controls (0.11%; P < .001). Mutations in EOC cases were more frequent in RAD51C (14 occurrences, 0.41%) and RAD51D (12 occurrences, 0.35%) than in RAD51B (two occurrences, 0.06%). RAD51C mutations were associated with an odds ratio of 5.2 (95% CI, 1.1 to 24; P = .035), and RAD51D mutations conferred an odds ratio of 12 (95% CI, 1.5 to 90; P = .019). We identified 13 RAD51 mutations (0.65%) in unaffected UK_FOCSS participants (RAD51C, n = 7; RAD51D, n = 5; and RAD51B, n = 1), which was a significantly greater rate than in controls (P < .001); furthermore, RAD51 mutation carriers were more likely than noncarriers to have a family history of ovarian cancer (P < .001). CONCLUSION: These results confirm that RAD51C and RAD51D are moderate ovarian cancer susceptibility genes and suggest that they confer levels of risk of EOC that may warrant their use alongside BRCA1 and BRCA2 in routine clinical genetic testing.
PURPOSE: The aim of this study was to estimate the contribution of deleterious mutations in the RAD51B, RAD51C, and RAD51D genes to invasive epithelial ovarian cancer (EOC) in the population and in a screening trial of individuals at high risk of ovarian cancer. PATIENTS AND METHODS: The coding sequence and splice site boundaries of the three RAD51 genes were sequenced and analyzed in germline DNA from a case-control study of 3,429 patients with invasive EOC and 2,772 controls as well as in 2,000 unaffected women who were BRCA1/BRCA2 negative from the United Kingdom Familial Ovarian Cancer Screening Study (UK_FOCSS) after quality-control analysis. RESULTS: In the case-control study, we identified predicted deleterious mutations in 28 EOC cases (0.82%) compared with three controls (0.11%; P < .001). Mutations in EOC cases were more frequent in RAD51C (14 occurrences, 0.41%) and RAD51D (12 occurrences, 0.35%) than in RAD51B (two occurrences, 0.06%). RAD51C mutations were associated with an odds ratio of 5.2 (95% CI, 1.1 to 24; P = .035), and RAD51D mutations conferred an odds ratio of 12 (95% CI, 1.5 to 90; P = .019). We identified 13 RAD51 mutations (0.65%) in unaffected UK_FOCSS participants (RAD51C, n = 7; RAD51D, n = 5; and RAD51B, n = 1), which was a significantly greater rate than in controls (P < .001); furthermore, RAD51 mutation carriers were more likely than noncarriers to have a family history of ovarian cancer (P < .001). CONCLUSION: These results confirm that RAD51C and RAD51D are moderate ovarian cancer susceptibility genes and suggest that they confer levels of risk of EOC that may warrant their use alongside BRCA1 and BRCA2 in routine clinical genetic testing.
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