Abstract
Introduction/Background
Published studies on association of germline monogenic genes and lung cancer risk
were inconsistent. Our objective is to assess the validity of reported candidate monogenic
genes for their association with lung cancer.
Materials and Methods
A systematic review of published papers prior to August 2022 was performed first to
identify all genes where germline mutations were associated with lung cancer risk.
We then performed a confirmation study in 2,050 lung cancer cases and 198,553 controls
in the UK Biobank (UKB). Germline mutations of these genes were identified from sequencing
data and annotated using The American College of Medical Genetics criteria. The robust
SKAT-O, a gene-based analysis that properly controls for false positives due to unbalanced
case-control ratio, was used for association tests adjusting for age at recruitment,
gender, and genetic background.
Results
The systematic review identified 12 genes that were statistically significantly associated
with lung cancer risk in at least one study (P < .05), including ATM, BLM, BRCA2, BRIP1, CHEK2, FANCA, FANCD2, MSH6, PMS1, RAD51C, RAD51D, and TP53. When pathogenic/likely pathogenic mutations were aggregated within each gene, the
association was confirmed for ATM (P = 4.47E-4) at the study-wise significance level (P < .0042, Bonferroni correction for 12 tests). Suggestive evidence of association
was found for 2 other genes, BRCA2 (P = .007) and TP53 (P = .03). Among these 3 genes, the lung cancer risks range from 1.95 (BRCA2) to 5.28 (TP53).
Conclusion
This study provides statistical evidence for association of previously reported genes
and lung cancer risk and has clinical utility for risk assessment and genetic counseling.
Keywords
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Article info
Publication history
Published online: January 25, 2023
Accepted:
January 19,
2023
Received in revised form:
January 9,
2023
Received:
September 7,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.