{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:31:19Z","timestamp":1789475479255,"version":"build-2803163510"},"reference-count":70,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"\n Importance<\/jats:title>\n Knowledge about the spectrum of diseases associated with hereditary cancer syndromes may improve disease diagnosis and management for patients and help to identify high-risk individuals.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To identify phenotypes associated with hereditary cancer genes through a phenome-wide association study.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This phenome-wide association study used health data from participants in 3 cohorts. The Electronic Medical Records and Genomics Sequencing (eMERGEseq) data set recruited predominantly healthy individuals from 10 US medical centers from July 16, 2016, through February 18, 2018, with a mean follow-up through electronic health records (EHRs) of 12.7 (7.4) years. The UK Biobank (UKB) cohort recruited participants from March 15, 2006, through August 1, 2010, with a mean (SD) follow-up of 12.4 (1.0) years. The Hereditary Cancer Registry (HCR) recruited patients undergoing clinical genetic testing at Vanderbilt University Medical Center from May 1, 2012, through December 31, 2019, with a mean (SD) follow-up through EHRs of 8.8 (6.5) years.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Germline variants in 23 hereditary cancer genes. Pathogenic and likely pathogenic variants for each gene were aggregated for association analyses.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Phenotypes in the eMERGEseq and HCR cohorts were derived from the linked EHRs. Phenotypes in UKB were from multiple sources of health-related data.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 214\u202f020 participants were identified, including 23 544 in eMERGEseq cohort (mean [SD] age, 47.8 [23.7] years; 12 611 women [53.6%]), 187 234 in the UKB cohort (mean [SD] age, 56.7 [8.1] years; 104 055 [55.6%] women), and 3242 in the HCR cohort (mean [SD] age, 52.5 [15.5] years; 2851 [87.9%] women). All 38 established gene-cancer associations were replicated, and 19 new associations were identified. These included the following 7 associations with neoplasms:\n CHEK2<\/jats:italic>\n with leukemia (odds ratio [OR],\u20093.81 [95% CI, 2.64-5.48]) and plasma cell neoplasms (OR,\u20093.12 [95% CI, 1.84-5.28]),\n ATM<\/jats:italic>\n with gastric cancer (OR,\u20094.27 [95% CI, 2.35-7.44]) and pancreatic cancer (OR,\u20094.44 [95% CI, 2.66-7.40]),\n MUTYH<\/jats:italic>\n (biallelic) with kidney cancer (OR,\u200932.28 [95% CI, 6.40-162.73]),\n MSH6<\/jats:italic>\n with bladder cancer (OR,\u20095.63 [95% CI, 2.75-11.49]), and\n APC<\/jats:italic>\n with benign liver\/intrahepatic bile duct tumors (OR,\u200952.01 [95% CI, 14.29-189.29]). The remaining 12 associations with nonneoplastic diseases included\n BRCA1\/2<\/jats:italic>\n with ovarian cysts (OR,\u20093.15 [95% CI, 2.22-4.46] and 3.12 [95% CI, 2.36-4.12], respectively),\n MEN1<\/jats:italic>\n with acute pancreatitis (OR,\u200933.45 [95% CI, 9.25-121.02]),\n APC<\/jats:italic>\n with gastritis and duodenitis (OR,\u20094.66 [95% CI, 2.61-8.33]), and\n PTEN<\/jats:italic>\n with chronic gastritis (OR,\u200915.68 [95% CI, 6.01-40.92]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings of this genetic association study analyzing the EHRs of 3 large cohorts suggest that these new phenotypes associated with hereditary cancer genes may facilitate early detection and better management of cancers. This study highlights the potential benefits of using EHR data in genomic medicine.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoncol.2022.0373","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T11:04:45Z","timestamp":1650539085000},"page":"835","source":"Crossref","is-referenced-by-count":48,"title":["Association of Pathogenic Variants in Hereditary Cancer Genes With Multiple Diseases"],"prefix":"10.1001","volume":"8","author":[{"given":"Chenjie","family":"Zeng","sequence":"first","affiliation":[{"name":"National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"Bastarache","sequence":"additional","affiliation":[{"name":"Center for Precision Medicine, Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Venner","sequence":"additional","affiliation":[{"name":"Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Hebbring","sequence":"additional","affiliation":[{"name":"Center for Human Genetics, Marshfield Clinic Research Institute, Marshfield, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin D.","family":"Andujar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Clinical and Translational Hereditary Cancer Program, Division of Genetic Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harris T.","family":"Bland","sequence":"additional","affiliation":[{"name":"Center for Precision Medicine, Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Crosslin","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics and Medical Education, University of Washington School of Medicine, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Pratap","sequence":"additional","affiliation":[{"name":"School of Graduate Studies and Research, Meharry Medical College, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayorinde","family":"Cooley","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Pacheco","sequence":"additional","affiliation":[{"name":"Center for Genetic Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt D.","family":"Christensen","sequence":"additional","affiliation":[{"name":"PRecisiOn Medicine Translational Research (PROMoTeR) Center, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts"},{"name":"Department of Population Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Perez","sequence":"additional","affiliation":[{"name":"Division of Genetics, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie L. 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