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Cumulative Burden of Colorectal Cancer-Associated Genetic Variants Is More Strongly Associated With Early-Onset vs Late-Onset Cancer

AN. Archambault, YR. Su, J. Jeon, M. Thomas, Y. Lin, DV. Conti, AK. Win, LC. Sakoda, I. Lansdorp-Vogelaar, EFP. Peterse, AG. Zauber, D. Duggan, AN. Holowatyj, JR. Huyghe, H. Brenner, M. Cotterchio, S. Bézieau, SL. Schmit, CK. Edlund, MC. Southey,...

. 2020 ; 158 (5) : 1274-1286.e12. [pub] 20191219

Language English Country United States

Document type Journal Article, Multicenter Study, Observational Study, Research Support, N.I.H., Extramural, Research Support, N.I.H., Intramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.

Grant support
R01 CA067941 NCI NIH HHS - United States
U01 HG004446 NHGRI NIH HHS - United States
K05 CA154337 NCI NIH HHS - United States
S10 OD020069 NIH HHS - United States
U01 CA067941 NCI NIH HHS - United States
HHSN268201100001I NHLBI NIH HHS - United States
R01 CA197350 NCI NIH HHS - United States
R01 CA076366 NCI NIH HHS - United States
R35 CA197735 NCI NIH HHS - United States
RC2 AG036607 NIA NIH HHS - United States
T32 HS026120 AHRQ HHS - United States
U01 HG004438 NHGRI NIH HHS - United States
U01 CA074799 NCI NIH HHS - United States
U10 CA037429 NCI NIH HHS - United States
U01 CA182883 NCI NIH HHS - United States
P01 CA087969 NCI NIH HHS - United States
HHSN261201000035C NCI NIH HHS - United States
HHSN261201000006C NCI NIH HHS - United States
P30 CA015704 NCI NIH HHS - United States
HHSN268201100004I NHLBI NIH HHS - United States
U24 CA074783 NCI NIH HHS - United States
R01 CA206279 NCI NIH HHS - United States
P01 CA055075 NCI NIH HHS - United States
N01 CN067009 NCI NIH HHS - United States
R01 CA151993 NCI NIH HHS - United States
HHSN268201100046C NHLBI NIH HHS - United States
P30 DK034987 NIDDK NIH HHS - United States
R01 CA048998 NCI NIH HHS - United States
UM1 CA182934 NCI NIH HHS - United States
R01 CA189184 NCI NIH HHS - United States
U01 CA167552 NCI NIH HHS - United States
HHSN268201100003C WHI NIH HHS - United States
Z01 CP010200 Intramural NIH HHS - United States
U24 CA074794 NCI NIH HHS - United States
U01 CA164930 NCI NIH HHS - United States
N01PC35137 NCI NIH HHS - United States
R01 CA066635 NCI NIH HHS - United States
U24 CA074806 NCI NIH HHS - United States
U01 CA206110 NCI NIH HHS - United States
R01 CA137178 NCI NIH HHS - United States
U24 CA097735 NCI NIH HHS - United States
U01 CA074794 NCI NIH HHS - United States
P30 CA008748 NCI NIH HHS - United States
U01 CA167551 NCI NIH HHS - United States
HHSN261201300011C CCR NIH HHS - United States
HHSN261201300012I NCI NIH HHS - United States
P30 CA076292 NCI NIH HHS - United States
P30 CA014089 NCI NIH HHS - United States
R01 CA081488 NCI NIH HHS - United States
N01PC35142 NCI NIH HHS - United States
HHSN271201100004C NIA NIH HHS - United States
R01 CA201407 NCI NIH HHS - United States
R01 CA063464 NCI NIH HHS - United States
P01 CA033619 NCI NIH HHS - United States
P20 CA233216 NCI NIH HHS - United States
UM1 CA186107 NCI NIH HHS - United States
HHSN268201100002C WHI NIH HHS - United States
R01 CA207371 NCI NIH HHS - United States
HHSN261201300021C NCI NIH HHS - United States
HHSN261201000035I NCI NIH HHS - United States
R01 CA042182 NCI NIH HHS - United States
U01 CA063464 NCI NIH HHS - United States
R01 CA060987 NCI NIH HHS - United States
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T32 ES013678 NIEHS NIH HHS - United States
R01 CA136726 NCI NIH HHS - United States
P30 CA016058 NCI NIH HHS - United States
R03 CA215775 NCI NIH HHS - United States
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N01RC37004 CCR NIH HHS - United States
U01 CA122839 NCI NIH HHS - United States
HHSN268201100002I NHLBI NIH HHS - United States
U01 CA074783 NCI NIH HHS - United States
N01 CN045165 NCI NIH HHS - United States
U24 CA074799 NCI NIH HHS - United States
P01 CA196569 NCI NIH HHS - United States
U01 CA074806 NCI NIH HHS - United States
U24 CA074800 NCI NIH HHS - United States
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K07 CA190673 NCI NIH HHS - United States
P30 CA071789 NCI NIH HHS - United States
HHSN261201000121C NCI NIH HHS - United States
MR/L01629X/1 Medical Research Council - United Kingdom
R37 CA054281 NCI NIH HHS - United States
U01 CA074800 NCI NIH HHS - United States
HHSN268201100001C WHI NIH HHS - United States
HHSN268201100004C WHI NIH HHS - United States
P30 CA042014 NCI NIH HHS - United States
U19 CA148107 NCI NIH HHS - United States
10124 Cancer Research UK - United Kingdom
NV15-27580A MZ0 CEP Register

BACKGROUND & AIMS: Early-onset colorectal cancer (CRC, in persons younger than 50 years old) is increasing in incidence; yet, in the absence of a family history of CRC, this population lacks harmonized recommendations for prevention. We aimed to determine whether a polygenic risk score (PRS) developed from 95 CRC-associated common genetic risk variants was associated with risk for early-onset CRC. METHODS: We studied risk for CRC associated with a weighted PRS in 12,197 participants younger than 50 years old vs 95,865 participants 50 years or older. PRS was calculated based on single nucleotide polymorphisms associated with CRC in a large-scale genome-wide association study as of January 2019. Participants were pooled from 3 large consortia that provided clinical and genotyping data: the Colon Cancer Family Registry, the Colorectal Transdisciplinary Study, and the Genetics and Epidemiology of Colorectal Cancer Consortium and were all of genetically defined European descent. Findings were replicated in an independent cohort of 72,573 participants. RESULTS: Overall associations with CRC per standard deviation of PRS were significant for early-onset cancer, and were stronger compared with late-onset cancer (P for interaction = .01); when we compared the highest PRS quartile with the lowest, risk increased 3.7-fold for early-onset CRC (95% CI 3.28-4.24) vs 2.9-fold for late-onset CRC (95% CI 2.80-3.04). This association was strongest for participants without a first-degree family history of CRC (P for interaction = 5.61 × 10-5). When we compared the highest with the lowest quartiles in this group, risk increased 4.3-fold for early-onset CRC (95% CI 3.61-5.01) vs 2.9-fold for late-onset CRC (95% CI 2.70-3.00). Sensitivity analyses were consistent with these findings. CONCLUSIONS: In an analysis of associations with CRC per standard deviation of PRS, we found the cumulative burden of CRC-associated common genetic variants to associate with early-onset cancer, and to be more strongly associated with early-onset than late-onset cancer, particularly in the absence of CRC family history. Analyses of PRS, along with environmental and lifestyle risk factors, might identify younger individuals who would benefit from preventive measures.

Behavioral and Epidemiology Research Group American Cancer Society Atlanta Georgia

Biomedicine Institute University of León León Spain

Broad Institute of Harvard and MIT Cambridge Massachusetts

Cancer Epidemiology and Intelligence Division Cancer Council Victoria Melbourne Victoria Australia

Cancer Prevention and Control Program Catalan Institute of Oncology IDIBELL L'Hospitalet de Llobregat Barcelona Spain

Cancer Risk Factors and Life Style Epidemiology Unit Institute for Cancer Research Prevention and Clinical Network ISPRO Florence Italy

Center for Gastrointestinal Biology and Disease University of North Carolina Chapel Hill North Carolina

Center for Precision Medicine and Department of Medical Oncology and Therapeutics Research City of Hope National Medical Center Duarte California

Center for Public Health Genomics University of Virginia Charlottesville Virginia

Centre de Recherche en Épidémiologie et Santé des Populations Facultés de Médecine Université Paris Saclay Gustave Roussy Villejuif France

Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne Melbourne Victoria Australia

Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts

CIBER in Epidemiology and Public Health Madrid Spain

Clalit National Cancer Control Center Haifa Israel

Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston Massachusetts

Clinical Genetics Service Department of Medicine Memorial Sloan Kettering Cancer Center New York New York

Colorectal Oncogenomics Group Department of Clinical Pathology The University of Melbourne Parkville Victoria Australia

Department of Biostatistics University of Washington Seattle Washington

Department of Cancer Biology and Genetics Comprehensive Cancer Center The Ohio State University Columbus Ohio

Department of Cancer Epidemiology H Lee Moffitt Cancer Center and Research Institute Tampa Florida

Department of Clinical Genetics Karolinska University Hospital Stockholm Sweden

Department of Clinical Sciences Faculty of Medicine University of Barcelona Barcelona Spain

Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center Haifa Israel

Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York New York

Department of Epidemiology Geisel School of Medicine at Dartmouth Lebanon New Hampshire

Department of Epidemiology Harvard T H Chan School of Public Health Harvard University Boston Massachusetts

Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland

Department of Epidemiology Regional Health Council IMIB Arrixaca Murcia University Murcia Spain

Department of Epidemiology School of Public Health and Institute of Health and Environment Seoul National University Seoul South Korea

Department of Epidemiology University of Michigan Ann Arbor Michigan

Department of Epidemiology University of Washington School of Public Health Seattle Washington

Department of Family Medicine University of Virginia Charlottesville Virginia

Department of General and Thoracic Surgery University Hospital Schleswig Holstein Campus Kiel Kiel Germany

Department of Health Science Research Mayo Clinic Scottsdale Arizona

Department of Immunology and Infectious Diseases Harvard T H Chan School of Public Health Harvard University Boston Massachusetts

Department of Internal Medicine University of Utah Salt Lake City Utah

Department of Medicine 1 University Hospital Dresden Technische Universität Dresden Dresden Germany

Department of Medicine and Epidemiology University of Pittsburgh Medical Center Pittsburgh Pennsylvania

Department of Medicine New York University School of Medicine New York New York

Department of Medicine Samuel Oschin Comprehensive Cancer Institute Cedars Sinai Medical Center Los Angeles California

Department of Medicine University of North Carolina School of Medicine Chapel Hill North Carolina

Department of Medicine Weill Cornell Medical College New York New York

Department of Molecular Biology of Cancer Institute of Experimental Medicine of the Czech Academy of Sciences Prague Czech Republic

Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden

Department of Nutrition Harvard T H Chan School of Public Health Harvard University Boston Massachusetts

Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland Ohio

Department of Preventive Medicine USC Norris Comprehensive Cancer Center Keck School of Medicine University of Southern California Los Angeles California

Department of Public Health and Primary Care University of Cambridge Cambridge UK

Department of Public Health Erasmus MC University Medical Center Rotterdam The Netherlands

Department of Public Health Solutions National Institute for Health and Welfare Helsinki Finland

Department of Radiation Sciences Oncology Unit Umeå University Umeå Sweden

Division of Cancer Control and Population Sciences National Cancer Institute Bethesda Maryland

Division of Cancer Epidemiology and Genetics National Cancer Institute National Institutes of Health Bethesda Maryland

Division of Cancer Epidemiology German Cancer Research Center Heidelberg Germany

Division of Clinical Epidemiology and Aging Research German Cancer Research Center Heidelberg Germany

Division of Epidemiology Department of Population Health New York University School of Medicine New York New York

Division of Gastroenterology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts

Division of Human Genetics Department of Internal Medicine The Ohio State University Comprehensive Cancer Center Columbus Ohio

Division of Human Nutrition and Health Wageningen University and Research Wageningen The Netherlands

Division of Laboratory Genetics Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota

Division of Medical Oncology Norris Comprehensive Cancer Center Keck School of Medicine University of Southern California Los Angeles California

Division of Preventive Oncology German Cancer Research Center Heidelberg Germany

Division of Public Health Sciences Department of Surgery Washington University in St Louis St Louis Missouri

Division of Research Kaiser Permanente Northern California Oakland California

Epidemiology Program University of Hawaii Cancer Center Honolulu Hawaii

Escuela Andaluza de Salud Pública CIBER de Epidemiología y Salud Pública Granada Spain

Faculty of Medicine and Biomedical Center in Pilsen Charles University Pilsen Czech Republic

Gastroenterology Department Hospital Clínic Institut d'Investigacions Biomèdiques August Pi i Sunyer University of Barcelona Barcelona Spain

Genentech Inc Basel Switzerland

Genetic Epidemiology Laboratory Department of Pathology The University of Melbourne Melbourne Australia

Genomic Medicine and Family Cancer Clinic The Royal Melbourne Hospital Parkville Victoria Australia

Genomic Medicine Group Galician Foundation of Genomic Medicine Instituto de Investigación Sanitaria de Santiago de Compostela Complejo Hospitalario Universitario de Santiago SERGAS Santiago de Compostela Spain

German Cancer Consortium Heidelberg Germany

Hellenic Health Foundation Athens Greece

Huntsman Cancer Institute and Department of Population Health Sciences University of Utah Salt Lake City Utah

Institute for Health Research Kaiser Permanente Colorado Aurora Colorado

Institute of Biology and Medical Genetics 1st Faculty of Medicine Charles University Prague Czech Republic

Institute of Cancer Research Department of Medicine 1 Medical University of Vienna Vienna Austria

Institute of Environmental Medicine Karolinska Institute Stockholm Sweden

Instituto de Investigación Sanitaria Galicia Sur Xerencia de Xestion Integrada de Vigo SERGAS Oncology and Genetics Unit Vigo Spain

Leeds Institute of Cancer and Pathology University of Leeds Leeds UK

Lunenfeld Tanenbaum Research Institute Mount Sinai Hospital University of Toronto Toronto Ontario Canada

Medical Faculty University of Heidelberg Heidelberg Germany

Memorial University of Newfoundland Discipline of Genetics St John's Newfoundland Canada

Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia

Moores Cancer Center University of California San Diego La Jolla California

Nuffield Department of Population Health University of Oxford Oxford UK

Nutrition and Metabolism Section International Agency for Research on Cancer World Health Organization Lyon France

Ontario Institute for Cancer Research Toronto Ontario Canada

Population Health and Prevention Cancer Care Ontario Toronto Ontario Canada

Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle Washington

Radiotherapy Department Complejo Hospitalario Universitario de Vigo SERGAS Vigo Spain

Ruth and Bruce Rappaport Faculty of Medicine Technion Israel Institute of Technology Haifa Israel

School of Public Health Imperial College London London UK

School of Public Health University of Washington Seattle Washington

Section of Nutrition and Metabolism International Agency for Research on Cancer Lyon France

Service de Génétique Médicale Centre Hospitalier Universitaire Nantes Nantes France

SWOG Statistical Center Fred Hutchinson Cancer Research Center Seattle Washington

The Clinical Epidemiology Unit Memorial University Medical School St John's Newfoundland Canada

Translational Genomics Research Institute An Affiliate of City of Hope Phoenix Arizona

University Medical Centre Hamburg Eppendorf University Cancer Centre Hamburg Hamburg Germany

University of Melbourne Centre for Cancer Research Victorian Comprehensive Cancer Centre Parkville Victoria Australia

Wallenberg Centre for Molecular Medicine Umeå University Umeå Sweden

References provided by Crossref.org

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$a BACKGROUND & AIMS: Early-onset colorectal cancer (CRC, in persons younger than 50 years old) is increasing in incidence; yet, in the absence of a family history of CRC, this population lacks harmonized recommendations for prevention. We aimed to determine whether a polygenic risk score (PRS) developed from 95 CRC-associated common genetic risk variants was associated with risk for early-onset CRC. METHODS: We studied risk for CRC associated with a weighted PRS in 12,197 participants younger than 50 years old vs 95,865 participants 50 years or older. PRS was calculated based on single nucleotide polymorphisms associated with CRC in a large-scale genome-wide association study as of January 2019. Participants were pooled from 3 large consortia that provided clinical and genotyping data: the Colon Cancer Family Registry, the Colorectal Transdisciplinary Study, and the Genetics and Epidemiology of Colorectal Cancer Consortium and were all of genetically defined European descent. Findings were replicated in an independent cohort of 72,573 participants. RESULTS: Overall associations with CRC per standard deviation of PRS were significant for early-onset cancer, and were stronger compared with late-onset cancer (P for interaction = .01); when we compared the highest PRS quartile with the lowest, risk increased 3.7-fold for early-onset CRC (95% CI 3.28-4.24) vs 2.9-fold for late-onset CRC (95% CI 2.80-3.04). This association was strongest for participants without a first-degree family history of CRC (P for interaction = 5.61 × 10-5). When we compared the highest with the lowest quartiles in this group, risk increased 4.3-fold for early-onset CRC (95% CI 3.61-5.01) vs 2.9-fold for late-onset CRC (95% CI 2.70-3.00). Sensitivity analyses were consistent with these findings. CONCLUSIONS: In an analysis of associations with CRC per standard deviation of PRS, we found the cumulative burden of CRC-associated common genetic variants to associate with early-onset cancer, and to be more strongly associated with early-onset than late-onset cancer, particularly in the absence of CRC family history. Analyses of PRS, along with environmental and lifestyle risk factors, might identify younger individuals who would benefit from preventive measures.
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700    1_
$a Su, Yu-Ru $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
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$a Jeon, Jihyoun $u Department of Epidemiology, University of Michigan, Ann Arbor, Michigan.
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$a Thomas, Minta $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
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$a Lin, Yi $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
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$a Conti, David V $u Department of Preventive Medicine, USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
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$a Win, Aung Ko $u Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
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$a Sakoda, Lori C $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Division of Research, Kaiser Permanente Northern California, Oakland, California.
700    1_
$a Lansdorp-Vogelaar, Iris $u Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
700    1_
$a Peterse, Elisabeth F P $u Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
700    1_
$a Zauber, Ann G $u Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
700    1_
$a Duggan, David $u Translational Genomics Research Institute, An Affiliate of City of Hope, Phoenix, Arizona.
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$a Cotterchio, Michelle $u Population Health and Prevention, Cancer Care Ontario, Toronto, Ontario, Canada.
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$a Bézieau, Stéphane $u Service de Génétique Médicale, Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France.
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$a Edlund, Christopher K $u Department of Preventive Medicine, USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
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$a Southey, Melissa C $u Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Melbourne, Australia.
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$a MacInnis, Robert J $u Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.
700    1_
$a Campbell, Peter T $u Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia.
700    1_
$a Chang-Claude, Jenny $u Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; University Medical Centre Hamburg-Eppendorf, University Cancer Centre Hamburg (UCCH), Hamburg, Germany.
700    1_
$a Slattery, Martha L $u Department of Internal Medicine, University of Utah, Salt Lake City, Utah.
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$a Chan, Andrew T $u Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Broad Institute of Harvard and MIT, Cambridge, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
700    1_
$a Joshi, Amit D $u Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
700    1_
$a Song, Mingyang $u Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
700    1_
$a Cao, Yin $u Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri.
700    1_
$a Woods, Michael O $u Memorial University of Newfoundland, Discipline of Genetics, St. John's, Newfoundland, Canada.
700    1_
$a White, Emily $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington.
700    1_
$a Weinstein, Stephanie J $u Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
700    1_
$a Ulrich, Cornelia M $u Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, Utah.
700    1_
$a Hoffmeister, Michael $u Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
700    1_
$a Bien, Stephanie A $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
700    1_
$a Harrison, Tabitha A $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
700    1_
$a Hampe, Jochen $u Department of Medicine I, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.
700    1_
$a Li, Christopher I $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
700    1_
$a Schafmayer, Clemens $u Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
700    1_
$a Offit, Kenneth $u Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
700    1_
$a Pharoah, Paul D $u Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
700    1_
$a Moreno, Victor $u Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
700    1_
$a Lindblom, Annika $u Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
700    1_
$a Wolk, Alicja $u Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
700    1_
$a Wu, Anna H $u Department of Preventive Medicine, USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
700    1_
$a Li, Li $u Department of Family Medicine, University of Virginia, Charlottesville, Virginia.
700    1_
$a Gunter, Marc J $u Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France.
700    1_
$a Gsur, Andrea $u Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
700    1_
$a Keku, Temitope O $u Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, North Carolina.
700    1_
$a Pearlman, Rachel $u Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio.
700    1_
$a Bishop, D Timothy $u Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.
700    1_
$a Castellví-Bel, Sergi $u Gastroenterology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain.
700    1_
$a Moreira, Leticia $u Gastroenterology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain.
700    1_
$a Vodicka, Pavel $u Department of Molecular Biology of Cancer, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czech Republic; Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague, Czech Republic; Faculty of Medicine and Biomedical Center in Pilsen, Charles University, Pilsen, Czech Republic.
700    1_
$a Kampman, Ellen $u Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
700    1_
$a Giles, Graham G $u Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
700    1_
$a Albanes, Demetrius $u Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington.
700    1_
$a Baron, John A $u Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
700    1_
$a Berndt, Sonja I $u Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington.
700    1_
$a Brezina, Stefanie $u Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
700    1_
$a Buch, Stephan $u Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, Utah.
700    1_
$a Buchanan, Daniel D $u Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria, Australia; Genomic Medicine and Family Cancer Clinic, The Royal Melbourne Hospital, Parkville, Victoria, Australia; University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, Victoria, Australia.
700    1_
$a Trichopoulou, Antonia $u Hellenic Health Foundation, Athens, Greece.
700    1_
$a Severi, Gianluca $u Centre de Recherche en Épidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, Gustave Roussy, Villejuif, France.
700    1_
$a Chirlaque, María-Dolores $u CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain.
700    1_
$a Sánchez, Maria-José $u Escuela Andaluza de Salud Pública, CIBER de Epidemiología y Salud Pública, Granada, Spain.
700    1_
$a Palli, Domenico $u Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy.
700    1_
$a Kühn, Tilman $u Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
700    1_
$a Murphy, Neil $u Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France.
700    1_
$a Cross, Amanda J $u School of Public Health, Imperial College London, London, UK.
700    1_
$a Burnett-Hartman, Andrea N $u Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado.
700    1_
$a Chanock, Stephen J $u Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington.
700    1_
$a de la Chapelle, Albert $u Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.
700    1_
$a Easton, Douglas F $u Department of Medicine, Weill Cornell Medical College, New York, New York.
700    1_
$a Elliott, Faye $u Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.
700    1_
$a English, Dallas R $u Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
700    1_
$a Feskens, Edith J M $u Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
700    1_
$a FitzGerald, Liesel M $u Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
700    1_
$a Goodman, Phyllis J $u SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington.
700    1_
$a Hopper, John L $u Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Department of Epidemiology, School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, South Korea.
700    1_
$a Hudson, Thomas J $u Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
700    1_
$a Hunter, David J $u Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts; Nuffield Department of Population Health, University of Oxford, Oxford, UK.
700    1_
$a Jacobs, Eric J $u Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia.
700    1_
$a Joshu, Corinne E $u Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
700    1_
$a Küry, Sébastien $u Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.
700    1_
$a Markowitz, Sanford D $u Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
700    1_
$a Milne, Roger L $u Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.
700    1_
$a Platz, Elizabeth A $u Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
700    1_
$a Rennert, Gad $u Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Clalit National Cancer Control Center, Haifa, Israel.
700    1_
$a Rennert, Hedy S $u Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Clalit National Cancer Control Center, Haifa, Israel.
700    1_
$a Schumacher, Fredrick R $u Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio.
700    1_
$a Sandler, Robert S $u Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, North Carolina.
700    1_
$a Seminara, Daniela $u Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
700    1_
$a Tangen, Catherine M $u SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington.
700    1_
$a Thibodeau, Stephen N $u Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
700    1_
$a Toland, Amanda E $u Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.
700    1_
$a van Duijnhoven, Franzel J B $u Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
700    1_
$a Visvanathan, Kala $u Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
700    1_
$a Vodickova, Ludmila $u Department of Molecular Biology of Cancer, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czech Republic; Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague, Czech Republic; Faculty of Medicine and Biomedical Center in Pilsen, Charles University, Pilsen, Czech Republic.
700    1_
$a Potter, John D $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
700    1_
$a Männistö, Satu $u Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.
700    1_
$a Weigl, Korbinian $u Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Medical Faculty, University of Heidelberg, Heidelberg, Germany.
700    1_
$a Figueiredo, Jane $u Department of Preventive Medicine, USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California.
700    1_
$a Martín, Vicente $u CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Biomedicine Institute (IBIOMED), University of León, León, Spain.
700    1_
$a Larsson, Susanna C $u Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
700    1_
$a Parfrey, Patrick S $u The Clinical Epidemiology Unit, Memorial University Medical School, St. John's, Newfoundland, Canada.
700    1_
$a Huang, Wen-Yi $u Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
700    1_
$a Lenz, Heinz-Josef $u Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
700    1_
$a Castelao, Jose E $u Instituto de Investigación Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Oncology and Genetics Unit, Vigo, Spain.
700    1_
$a Gago-Dominguez, Manuela $u Genomic Medicine Group, Galician Foundation of Genomic Medicine, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain; Moores Cancer Center, University of California San Diego, La Jolla, California.
700    1_
$a Muñoz-Garzón, Victor $u Radiotherapy Department, Complejo Hospitalario Universitario de Vigo, SERGAS, Vigo, Spain.
700    1_
$a Mancao, Christoph $u Genentech, Inc., Basel, Switzerland.
700    1_
$a Haiman, Christopher A $u Department of Preventive Medicine, USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
700    1_
$a Wilkens, Lynne R $u Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
700    1_
$a Siegel, Erin $u Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
700    1_
$a Barry, Elizabeth $u Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
700    1_
$a Younghusband, Ban $u Memorial University of Newfoundland, Discipline of Genetics, St. John's, Newfoundland, Canada.
700    1_
$a Van Guelpen, Bethany $u Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden; Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden.
700    1_
$a Harlid, Sophia $u Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden.
700    1_
$a Zeleniuch-Jacquotte, Anne $u Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, New York.
700    1_
$a Liang, Peter S $u Department of Medicine, New York University School of Medicine, New York, New York.
700    1_
$a Du, Mengmeng $u Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
700    1_
$a Casey, Graham $u Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia.
700    1_
$a Lindor, Noralane M $u Department of Health Science Research, Mayo Clinic, Scottsdale, Arizona.
700    1_
$a Le Marchand, Loic $u Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
700    1_
$a Gallinger, Steven J $u Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
700    1_
$a Jenkins, Mark A $u Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
700    1_
$a Newcomb, Polly A $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; School of Public Health, University of Washington, Seattle, Washington.
700    1_
$a Gruber, Stephen B $u Center for Precision Medicine & Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California.
700    1_
$a Schoen, Robert E $u Department of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
700    1_
$a Hampel, Heather $u Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio.
700    1_
$a Corley, Douglas A $u Division of Research, Kaiser Permanente Northern California, Oakland, California.
700    1_
$a Hsu, Li $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Biostatistics, University of Washington, Seattle, Washington.
700    1_
$a Peters, Ulrike $u Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Memorial University of Newfoundland, Discipline of Genetics, St. John's, Newfoundland, Canada. Electronic address: upeters@fredhutch.org.
700    1_
$a Hayes, Richard B $u Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, New York. Electronic address: richard.b.hayes@nyulangone.org.
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