Clin Colon Rectal Surg 2016; 29(04): 345-352
DOI: 10.1055/s-0036-1584087
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Genetic Testing for Polyposis Syndromes

Khateriaa Pyrtel
1   Center for Medical Genetics, NorthShore University HealthSystem, Evanston, Illinois
› Author Affiliations
Further Information

Publication History

Publication Date:
21 November 2016 (online)

Abstract

Colorectal cancer is the third most common cancer diagnosed in the United States with up to 3% of cases being attributable to a hereditary polyposis syndrome. Established diagnostic and/or testing criteria exist for many of the recognized polyposis syndromes and are an important tool in guiding physicians in the identification of individuals who may benefit from referral to a cancer genetics service for hereditary cancer risk assessment. A formal hereditary cancer risk assessment supports fulfillment of obligations for standard of care, as well as minimizes the negative outcomes that may occur in the absence of informed consent for genetic testing. The implications of a diagnosis may extend beyond the individual patient to include at-risk relatives, and as such, much emphasis should be placed on identifying the most informative individual in a family in which to initiate testing. Advances in our understanding of genes associated with hereditary polyposis and the increasing use of testing that relies on next-generation sequencing technologies may lead to the increased likelihood of a genetic diagnosis; however, in those individuals without a genetic diagnosis whose histories remain concerning for hereditary polyposis, knowledge of family history may inform strategies for early detection and prevention.

 
  • References

  • 1 1. SEER Cancer Statistics Factsheets: Colon and Rectum Cancer. National Cancer Institute. Bethesda, MD: . Available at: http://seer.cancer.gov/statfacts/html/colorect.html . Accessed 10/2/ 2015
  • 2 Syngal S, Brand RE, Church JM, Giardiello FM, Hampel HL, Burt RW ; American College of Gastroenterology. ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol 2015; 110 (2) 223-262 , quiz 263
  • 3 Hampel H, Bennett RL, Buchanan A, Pearlman R, Wiesner GL ; Guideline Development Group, American College of Medical Genetics and Genomics Professional Practice and Guidelines Committee and National Society of Genetic Counselors Practice Guidelines Committee. A practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment. Genet Med 2015; 17 (1) 70-87
  • 4 Riley BD, Culver JO, Skrzynia C , et al. Essential elements of genetic cancer risk assessment, counseling, and testing: updated recommendations of the National Society of Genetic Counselors. J Genet Couns 2012; 21 (2) 151-161
  • 5 Rubinstein WS, Weissman SM. Managing hereditary gastrointestinal cancer syndromes: the partnership between genetic counselors and gastroenterologists. Nat Clin Pract Gastroenterol Hepatol 2008; 5 (10) 569-582
  • 6 Lu KH, Wood ME, Daniels M , et al; American Society of Clinical Oncology. American Society of Clinical Oncology Expert Statement: collection and use of a cancer family history for oncology providers. J Clin Oncol 2014; 32 (8) 833-840
  • 7 National Human Genome Research Institute (NHGRI). A brief history of the human genome project. Last updated November 8 2012. Available at: http://www.genome.gov/12011239 . Accessed September 29, 2015
  • 8 Esteban-Jurado C, Garre P, Vila M , et al. New genes emerging for colorectal cancer predisposition. World J Gastroenterol 2014; 20 (8) 1961-1971
  • 9 Heald B, Church J. Genetic testing for hereditary colorectal cancer syndromes: a significant change in technology and its clinical implications. Colorectal Dis 2014; 16 (12) 942-946
  • 10 Ku CS, Cooper DN, Roukos DH. Clinical relevance of cancer genome sequencing. World J Gastroenterol 2013; 19 (13) 2011-2018
  • 11 Esplin ED, Snyder MP. Genomic era diagnosis and management of hereditary and sporadic colon cancer. World J Clin Oncol 2014; 5 (5) 1036-1047
  • 12 Simbolo M, Mafficini A, Agostini M , et al. Next-generation sequencing for genetic testing of familial colorectal cancer syndromes. Hered Cancer Clin Pract 2015; 13 (1) 18
  • 13 Online Mendelian Inheritance in Man. OMIM®. Johns Hopkins University, Baltimore, MD. MIM Number: 175100: Last edited June 10, 2015. World Wide Web URL: http://www.omim.org/entry/175100
  • 14 Valle L. Genetic predisposition to colorectal cancer: where we stand and future perspectives. World J Gastroenterol 2014; 20 (29) 9828-9849
  • 15 Online Mendelian Inheritance in Man. OMIM®. Johns Hopkins University, Baltimore, MD. MIM Number:608456: Last edited June 10, 2015. World Wide Web URL: http://www.omim.org/entry/608456
  • 16 Grover S, Kastrinos F, Steyerberg EW , et al. Prevalence and phenotypes of APC and MUTYH mutations in patients with multiple colorectal adenomas. JAMA 2012; 308 (5) 485-492
  • 17 Palles C, Cazier JB, Howarth KM , et al; CORGI Consortium; WGS500 Consortium. Germline mutations affecting the proofreading domains of POLE and POLD1 predispose to colorectal adenomas and carcinomas. Nat Genet 2013; 45 (2) 136-144
  • 18 Valle L, Hernández-Illán E, Bellido F , et al. New insights into POLE and POLD1 germline mutations in familial colorectal cancer and polyposis. Hum Mol Genet 2014; 23 (13) 3506-3512
  • 19 Bellido F, Pineda M, Aiza G , et al. POLE and POLD1 mutations in 529 kindred with familial colorectal cancer and/or polyposis: review of reported cases and recommendations for genetic testing and surveillance. Genet Med 2016; 18 (4) 325-332
  • 20 Spier I, Holzapfel S, Altmüller J , et al. Frequency and phenotypic spectrum of germline mutations in POLE and seven other polymerase genes in 266 patients with colorectal adenomas and carcinomas. Int J Cancer 2015; 137 (2) 320-331
  • 21 Gammon A, Jasperson K, Kohlmann W, Burt RW. Hamartomatous polyposis syndromes. Best Pract Res Clin Gastroenterol 2009; 23 (2) 219-231
  • 22 Online Mendelian Inheritance in Man. OMIM®. Johns Hopkins University, Baltimore, MD. MIM Number:174900: Last edited August 26, 2008 . World Wide Web URL: http://www.omim.org/entry/174900
  • 23 Online Mendelian Inheritance in Man. OMIM®. Johns Hopkins University, Baltimore, MD. MIM Number:158350: Last edited October 10, 2014 . World Wide Web URL: http://www.omim.org/entry/158350
  • 24 Online Mendelian Inheritance in Man. OMIM®. Johns Hopkins University, Baltimore, MD. MIM Number:175200: Last edited March 9, 2015 . World Wide Web URL: http://www.omim.org/entry/175200
  • 25 Aretz S, Stienen D, Uhlhaas S , et al. High proportion of large genomic deletions and a genotype phenotype update in 80 unrelated families with juvenile polyposis syndrome. J Med Genet 2007; 44 (11) 702-709
  • 26 Zbuk KM, Eng C. Hamartomatous polyposis syndromes. Nat Clin Pract Gastroenterol Hepatol 2007; 4 (9) 492-502
  • 27 Ngeow J, Eng C. PTEN hamartoma tumor syndrome: clinical risk assessment and management protocol. Methods 2015; 77–78: 11-19
  • 28 National Comprehensive Cancer Network (NCCN). NCCN Genetic/Familial High Risk Assessment: Breast and Ovarian Version 2. 2015 . Available at: http://www.nccn.org/professionals/physician_gls/pdf/genetics_colon.pdf . Accessed October 2, 2015
  • 29 Tan MH, Mester J, Peterson C , et al. A clinical scoring system for selection of patients for PTEN mutation testing is proposed on the basis of a prospective study of 3042 probands. Am J Hum Genet 2011; 88 (1) 42-56
  • 30 Eng C. Will the real Cowden syndrome please stand up: revised diagnostic criteria. J Med Genet 2000; 37 (11) 828-830
  • 31 Beggs AD, Latchford AR, Vasen HF , et al. Peutz-Jeghers syndrome: a systematic review and recommendations for management. Gut 2010; 59 (7) 975-986
  • 32 Ngeow J, Heald B, Rybicki LA , et al. Prevalence of germline PTEN, BMPR1A, SMAD4, STK11, and ENG mutations in patients with moderate-load colorectal polyps. Gastroenterology 2013; 144 (7) 1402-1409 , 1409.e1–1409.e5
  • 33 Rex DK, Ahnen DJ, Baron JA , et al. Serrated lesions of the colorectum: review and recommendations from an expert panel. Am J Gastroenterol 2012; 107 (9) 1315-1329 , quiz 1314, 1330
  • 34 Guarinos C, Sánchez-Fortún C, Rodríguez-Soler M, Alenda C, Payá A, Jover R. Serrated polyposis syndrome: molecular, pathological and clinical aspects. World J Gastroenterol 2012; 18 (20) 2452-2461