{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:03:38Z","timestamp":1784199818963,"version":"3.55.0"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the prevalence, characteristics, and clinical implications of germline mutations in a consecutive cohort of Chinese colorectal cancer (CRC) patients, providing insights that may inform population\u2010specific genetic testing strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1094 CRC patients from two centers were retrospectively analyzed using a 53\u2010gene hereditary cancer panel. Germline variants were classified according to ACMG\/AMP guidelines. Clinical characteristics, molecular features, and survival outcomes were examined, and mutation frequencies were compared with published data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Germline pathogenic\/likely pathogenic (P\/LP) mutations were identified in 9.3% of patients, with mismatch repair (MMR) genes most frequently affected (4.2%). Higher mutation rates were associated with early\u2010onset CRC, nonmetastatic disease, and a family history of cancer. Compared to Western populations, Chinese patients showed significantly lower frequencies of\n                      <jats:italic>MUTYH<\/jats:italic>\n                      and\n                      <jats:italic>APC<\/jats:italic>\n                      mutations (both 0.4% vs. 2.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) but higher rates of MMR mutations. Among the 106 germline variants detected, 63.2% were in NCCN\u2010recommended genes, while 36.8% were found in non\u2010NCCN genes, primarily within homologous recombination repair and Fanconi anemia pathways. Patients harboring germline P\/LP mutations had significantly better progression\u2010free survival (HR\u2009=\u20090.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Notably, 50.0% of mutation carriers had no family history, and 29.4% were diagnosed after age 65, highlighting the limitations of current criteria\u2010based testing strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study reveals distinct germline mutation patterns and clinical features in Chinese CRC patients, underscoring the need for population\u2010specific genetic testing and tailored screening to improve prevention, early detection, and personalized treatment in Asian populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71848","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:26:42Z","timestamp":1779942402000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distinct Germline Mutation Landscape and Clinical Implications in Chinese Colorectal Cancer: A Large\u2010Scale Genomic Analysis of 1094 Patients"],"prefix":"10.1002","volume":"15","author":[{"given":"Liting","family":"Lu","sequence":"first","affiliation":[{"name":"Cancer Medical Center, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery Affiliated Hospital of Hebei University  Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Cancer Medical Center, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing 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Chinese Academy of Medical Science &amp; Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xicheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Cancer Medical Center, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Ba","sequence":"additional","affiliation":[{"name":"Cancer Medical Center, Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College  Beijing 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