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Abstract Background Previous genome-wide association studies (GWAS) have identified 42 loci (P < 5 × 10−8) associated with risk of colorectal cancer (CRC). Expanded consortium efforts facilitating the discovery of additional susceptibility loci may capture unexplained familial risk. Methods We conducted a GWAS in European descent CRC cases and control subjects using a discovery–replication design, followed by examination of novel findings in a multiethnic sample (cumulative n = 163 315). In the discovery stage (36 948 case subjects/30 864 control subjects), we identified genetic variants with a minor allele frequency of 1% or greater associated with risk of CRC using logistic regression followed by a fixed-effects inverse variance weighted meta-analysis. All novel independent variants reaching genome-wide statistical significance (two-sided P < 5 × 10−8) were tested for replication in separate European ancestry samples (12 952 case subjects/48 383 control subjects). Next, we examined the generalizability of discovered variants in East Asians, African Americans, and Hispanics (12 085 case subjects/22 083 control subjects). Finally, we examined the contributions of novel risk variants to familial relative risk and examined the prediction capabilities of a polygenic risk score. All statistical tests were two-sided. Results The discovery GWAS identified 11 variants associated with CRC at P < 5 × 10−8, of which nine (at 4q22.2/5p15.33/5p13.1/6p21.31/6p12.1/10q11.23/12q24.21/16q24.1/20q13.13) independently replicated at a P value of less than .05. Multiethnic follow-up supported the generalizability of discovery findings. These results demonstrated a 14.7% increase in familial relative risk explained by common risk alleles from 10.3% (95% confidence interval [CI] = 7.9% to 13.7%; known variants) to 11.9% (95% CI = 9.2% to 15.5%; known and novel variants). A polygenic risk score identified 4.3% of the population at an odds ratio for developing CRC of at least 2.0. Conclusions This study provides insight into the architecture of common genetic variation contributing to CRC etiology and improves risk prediction for individualized screening.
Prevention (rcdc), Ethnic Groups/genetics, Ethnicity (mesh), Clinical Research (rcdc), Ethnicity, 2.1 Biological and endogenous factors, 32 Biomedical and Clinical Sciences (for-2020), Genetic Loci (mesh), Genetic Predisposition to Disease (mesh), Cancer, Colo-Rectal Cancer (rcdc), Genome-Wide Association Study*, Cancer (rcdc), Humans (mesh), Follow-Up Studies (mesh), Single Nucleotide, 1112 Oncology and Carcinogenesis (for), United States/epidemiology, Prognosis, Colo-Rectal Cancer, /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being, Genome-Wide Association Study (mesh), Colorectal Neoplasms, United States (mesh), Colorectal Neoplasms / genetics*, Digestive Diseases (rcdc), Single Nucleotide (mesh), Genotype, Colorectal Neoplasms (mesh), Oncology and Carcinogenesis, Colorectal Neoplasms / epidemiology*, 610, Polymorphism, Single Nucleotide, Case-Control Studies (mesh), Clinical Research, Càncer colorectal, Genetics, 3211 Oncology and carcinogenesis (for-2020), Life Science, Humans, Genetic Predisposition to Disease, Oncology & Carcinogenesis, Polymorphism, Colorectal Neoplasms/epidemiology, Ethnicity / statistics & numerical data, United States / epidemiology, Biomedical and Clinical Sciences, Ethnicity / genetics*, Genetics (rcdc), Genotype (mesh), Prevention, Human Genome, 2.1 Biological and endogenous factors (hrcs-rac), Prognosis (mesh), Single Nucleotide*, Human Genome (rcdc), Colorectal cancer, United States, name=SDG 3 - Good Health and Well-being, 3211 Oncology and Carcinogenesis (for-2020), Oncology & Carcinogenesis (science-metrix), Genetic Loci, Case-Control Studies, Genetic Predisposition to Disease*, Digestive Diseases, Genètica, Genetic Loci*, Follow-Up Studies, Genome-Wide Association Study
Prevention (rcdc), Ethnic Groups/genetics, Ethnicity (mesh), Clinical Research (rcdc), Ethnicity, 2.1 Biological and endogenous factors, 32 Biomedical and Clinical Sciences (for-2020), Genetic Loci (mesh), Genetic Predisposition to Disease (mesh), Cancer, Colo-Rectal Cancer (rcdc), Genome-Wide Association Study*, Cancer (rcdc), Humans (mesh), Follow-Up Studies (mesh), Single Nucleotide, 1112 Oncology and Carcinogenesis (for), United States/epidemiology, Prognosis, Colo-Rectal Cancer, /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being, Genome-Wide Association Study (mesh), Colorectal Neoplasms, United States (mesh), Colorectal Neoplasms / genetics*, Digestive Diseases (rcdc), Single Nucleotide (mesh), Genotype, Colorectal Neoplasms (mesh), Oncology and Carcinogenesis, Colorectal Neoplasms / epidemiology*, 610, Polymorphism, Single Nucleotide, Case-Control Studies (mesh), Clinical Research, Càncer colorectal, Genetics, 3211 Oncology and carcinogenesis (for-2020), Life Science, Humans, Genetic Predisposition to Disease, Oncology & Carcinogenesis, Polymorphism, Colorectal Neoplasms/epidemiology, Ethnicity / statistics & numerical data, United States / epidemiology, Biomedical and Clinical Sciences, Ethnicity / genetics*, Genetics (rcdc), Genotype (mesh), Prevention, Human Genome, 2.1 Biological and endogenous factors (hrcs-rac), Prognosis (mesh), Single Nucleotide*, Human Genome (rcdc), Colorectal cancer, United States, name=SDG 3 - Good Health and Well-being, 3211 Oncology and Carcinogenesis (for-2020), Oncology & Carcinogenesis (science-metrix), Genetic Loci, Case-Control Studies, Genetic Predisposition to Disease*, Digestive Diseases, Genètica, Genetic Loci*, Follow-Up Studies, Genome-Wide Association Study
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