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Here, in more than 3.3 million individuals, the\n                    <jats:italic toggle=\"yes\">EGFR<\/jats:italic>\n                    T790M germline variant is significantly associated with lung cancer risk, with no increased risk for 17 other cancers and no interaction with polygenic risk. This risk exceeds that conferred by smoking and is several-fold higher in never-smokers. Global geographic and ancestry analyses show higher T790M prevalence in the US than in British- and Irish-descendant populations, reflecting a Southern Appalachian founder event about 200 to 225 years ago, increasing regional prevalence and affecting those of British, Irish, and African descent. Recognition of high-risk carriers may inform targeted genetic testing and screening strategies.\n                  <\/jats:p>","DOI":"10.1126\/science.aec0473","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:02:51Z","timestamp":1789668171000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Germline\n                    <i>EGFR<\/i>\n                    T790M mutation and lung cancer risk"],"prefix":"10.1126","volume":"393","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0043-0206","authenticated-orcid":true,"given":"Jaclyn","family":"LoPiccolo","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."},{"name":"The Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3842-0946","authenticated-orcid":true,"given":"Steven","family":"Micheletti","sequence":"additional","affiliation":[{"name":"23andMe Research Institute, Palo Alto, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9671-2568","authenticated-orcid":true,"given":"Jing","family":"Shi","sequence":"additional","affiliation":[{"name":"23andMe Research Institute, Palo Alto, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7358-6557","authenticated-orcid":true,"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"23andMe Research Institute, Palo Alto, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubham","family":"Saini","sequence":"additional","affiliation":[{"name":"23andMe Research Institute, Palo Alto, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keng-Han","family":"Lin","sequence":"additional","affiliation":[{"name":"23andMe Research Institute, Palo Alto, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanwan","family":"Xu","sequence":"additional","affiliation":[{"name":"23andMe Research Institute, Palo Alto, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8944-4454","authenticated-orcid":true,"given":"Pierre","family":"Fontanillas","sequence":"additional","affiliation":[{"name":"23andMe Research Institute, Palo Alto, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"23andMe Research Team\u2021","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1217-9514","authenticated-orcid":true,"given":"Diane R.","family":"Koeller","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."},{"name":"Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7740-0486","authenticated-orcid":true,"given":"Helen","family":"Yatzus","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."},{"name":"Division of Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria G.","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."},{"name":"The Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7090-2724","authenticated-orcid":true,"given":"Jose A.","family":"Avila","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."},{"name":"The Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8198-5820","authenticated-orcid":true,"given":"Raphael B.","family":"Liautaud","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."},{"name":"The Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah D.","family":"Fields","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA."},{"name":"The Eli and Edythe L. 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