Abstract
The p16-Leiden germline variant in the CDKN2A gene is associated with a high risk of melanoma and pancreatic cancer. The aims of this study were to assess the risk of developing other cancers and to determine whether tobacco use would alter cancer risk in carriers of such a variant. We therefore prospectively evaluated individuals with a p16-Leiden germline variant, participating in a pancreatic surveillance programme, for the occurrence of cancer (n=150). Tobacco use was assessed at the start of the surveillance programme. We found a significantly increased risk for melanoma (relative risk (RR) 41.3; 95% confidence interval (CI) 22.9–74.6) and pancreatic cancer (RR 80.8; 95% CI 44.7–146). In addition, increased risks were found for cancers of the lip, mouth and pharynx (RR 18.8; 95% CI 6.05–58.2) and respiratory tumours (RR 4.56; 95% CI 1.71–12.1). Current smokers developed significantly more cancers of the lip, mouth and pharynx, respiratory system and pancreas compared with former and never-smokers. In conclusion, this study shows that carriers of a p16-Leiden variant have an increased risk of developing various types of cancer, and smoking significantly increases the risk of frequently occurring cancers. Smoking cessation should be an integral part of the management of p16-Leiden variant carriers.
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References
Hayward NK : Genetics of melanoma predisposition. Oncogene 2003; 22: 3053–3062.
Goldstein AM : Familial melanoma, pancreatic cancer and germline CDKN2A mutations. Hum Mutat 2004; 23: 630.
Gruis NA, van der Velden PA, Sandkuijl LA et al.. Homozygotes for CDKN2 (p16) germline mutation in Dutch familial melanoma kindreds. Nat Genet 1995; 10: 351–353.
Vasen HF, Gruis NA, Frants RR, van der Velden PA, Hille ET, Bergman W : Risk of developing pancreatic cancer in families with familial atypical multiple mole melanoma associated with a specific 19 deletion of p16 (p16-Leiden). Int J Cancer 2000; 87: 809–811.
Vasen HF, Wasser M, van Mil A et al.. Magnetic resonance imaging surveillance detects early-stage pancreatic cancer in carriers of a p16-Leiden mutation. Gastroenterology 2011; 140: 850–856.
de Snoo FA, Bishop DT, Bergman W et al.. Increased risk of cancer other than melanoma in CDKN2A founder mutation (p16-Leiden)-positive melanoma families. Clin Cancer Res 2008; 14: 7151–7157.
Goldstein AM, Struewing JP, Fraser MC, Smith MW, Tucker MA : Prospective risk of cancer in CDKN2A germline mutation carriers. J Med Genet 2004; 41: 421–424.
Mukherjee B, Delancey JO, Raskin L et al.. Risk of non-melanoma cancers in first-degree relatives of CDKN2A mutation carriers. J Natl Cancer Inst 2012; 104: 953–956.
Ghiorzo P, Ciotti P, Mantelli M et al.. Characterization of ligurian melanoma families and risk of occurrence of other neoplasia. Int J Cancer 1999; 83: 441–448.
Borg A, Sandberg T, Nilsson K et al.. High frequency of multiple melanomas and breast and pancreas carcinomas in CDKN2A mutation-positive melanoma families. J Natl Cancer Inst 2000; 92: 1260–1266.
Netherlands Cancer Registry, managed by IKNL. [cited 2013 1 April]. Available from www.cancerregistry.nl.
Korse CM, Taal BG, van Velthuysen ML, Visser O : Incidence and survival of neuroendocrine tumours in the Netherlands according to histological grade: experience of two decades of cancer registry. Eur J Cancer 2013; 49: 1975–1983.
van der Rhee JI, Krijnen P, Gruis NA et al.. Clinical and histologic characteristics of malignant melanoma in families with a germline mutation in CDKN2A. J Am Acad Dermatol 2011; 65: 281–288.
Rybicki BA, Iannuzzi MC : Epidemiology of sarcoidosis: recent advances and future prospects. Semin Respir Crit Care Med 2007; 28: 22–35.
Oldenburg RA, de Vos tot Nederveen Cappel WH, van Puijenbroek M et al.. Extending the p16-Leiden tumour spectrum by respiratory tract tumours. J Med Genet 2004; 41: e31.
Cabanillas R, Astudillo A, Valle M et al.. Novel germline CDKN2A mutation associated with head and neck squamous cell carcinomas and melanomas. Head Neck 2013; 35: E80–E84.
Vinarsky V, Fine RL, Assaad A et al.. Head and neck squamous cell carcinoma in FAMMM syndrome. Head Neck 2009; 31: 1524–1527.
Arnold CN, Sosnowski A, Schmitt-Graff A, Arnold R, Blum HE : Analysis of molecular pathways in sporadic neuroendocrine tumors of the gastro-entero-pancreatic system. Int J Cancer 2007; 120: 2157–2164.
Serrano J, Goebel SU, Peghini PL, Lubensky IA, Gibril F, Jensen RT : Alterations in the p16INK4a/CDKN2A tumor suppressor gene in gastrinomas. J Clin Endocrinol Metab 2000; 85: 4146–4156.
Acknowledgements
We would like to thank Dr R Wolterbeek for statistical support. This research was supported by the ZOLEON foundation (no. 12.09 to HFAV).
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Potjer, T., Kranenburg, H., Bergman, W. et al. Prospective risk of cancer and the influence of tobacco use in carriers of the p16-Leiden germline variant. Eur J Hum Genet 23, 711–714 (2015). https://doi.org/10.1038/ejhg.2014.187
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DOI: https://doi.org/10.1038/ejhg.2014.187
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