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Association of RPS20 Loss-of-Function Variants With Colorectal Cancer Risk in a Cohort of Over 950,000 Individuals
Jennifer Herrera-Mullar1, Cassidy Carraway1, Ashley P L Marsh1
1Ambry Genetics Corporation, Aliso Viejo, CA.
RPS20 gene variants increase colorectal cancer risk, particularly early-onset, signet ring cell types. Management recommendations for RPS20 heterozygotes should align with Lynch syndrome guidelines.
Area of Science:
- Genetics
- Oncology
- Cancer Predisposition
Background:
- RPS20 is a proposed colorectal cancer (CRC) predisposition gene.
- Limited data exists on RPS20 heterozygote prevalence, phenotype, and management.
Purpose of the Study:
- To determine the prevalence and clinical characteristics of RPS20 loss-of-function variants.
- To compare CRC risk in RPS20 heterozygotes with Lynch syndrome cohorts.
Main Methods:
- Retrospective review of ~950,000 individuals from multigene panel testing (MGPT).
- Identified 36 individuals with RPS20 putative loss-of-function (pLoF) variants.
- Compared clinical features, tumor prevalence, and age at onset with Lynch syndrome (LS) and wild-type (WT) cohorts.
Main Results:
- 36 individuals (0.004%) harbored RPS20 pLoF variants, with 78.6% developing CRC (median age 50).
- Signet ring cell (SRC) pathology was significantly enriched (P < .0001).
- RPS20 carriers had a significantly higher odds ratio for CRC compared to MLH1-related LS.
Conclusions:
- RPS20 is associated with early-onset, mismatch repair-proficient (pMMR) CRC enriched for SRC pathology.
- RPS20 heterozygotes have a two-fold increased odds of CRC compared to MLH1-related LS.
- Clinical management guidelines for RPS20 heterozygotes should resemble those for MLH1-related LS.
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