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        Genomics Precision Diagnostic > Oncology > Oncology Hereditary Colorectal Cancer

        Hereditary Colorectal Cancer

        Hereditary cancer syndromes are encountered in all medical specialties. Although they account for about 5% of all malignancies, it is of special importance to identify these patients because, unlike patients with sporadic cancers, they require special, long-term care as their predisposition can cause them to develop certain tumors at a relatively early age.
        The Igenomix Hereditary Colorectal Cancer Precision Panel provides a comprehensive analysis of the most common hereditary Colorectal Cancer syndromes using next-generation sequencing (NGS) to fully understand the spectrum of relevant colorectal cancer predisposition genes.
        Overview
        Indication
        Clinical Utility
        Genes & Diseases
        Methodology
        References

        Overview

        • Hereditary cancer syndromes are encountered in all medical specialties. Although they account for about 5% of all malignancies, it is of special importance to identify these patients because, unlike patients with sporadic cancers, they require special, long-term care as their predisposition can cause them to develop certain tumors at a relatively early age. These cancers can arise in the lungs, kidneys, liver, pancreas, skin, eyes, heart. Most hereditary cancers are associated with a “germline mutation” that will be present in every cell of the human body. Identification of patients at risk of inherited cancer susceptibility is dependent upon the ability to characterize genes and alterations associated with increased cancer risk as well as gathering a detailed personal and family history aiding in the identification of the mode of inheritance as well as other family members at risk of suffering from this susceptibility. Most hereditary cancer syndromes follow an autosomal dominant inheritance, and the penetrance is high.  
        • The Igenomix Hereditary Colorectal Cancer Precision Panel provides a comprehensive analysis of the most common hereditary Colorectal Cancer syndromes using next-generation sequencing (NGS) to fully understand the spectrum of relevant colorectal cancer predisposition genes.  

        Indication

        The Igenomix Hereditary Colorectal Cancer Panel is indicated as a screening and diagnostic test in those cases where there is: 

        • Family history of colorectal cancer (CRC) or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC). 
        • Family or personal history of Lynch syndrome or Lynch-like syndrome. 
        • History of multiple colorectal adenomas. 
        • Asymptomatic patient who wishes to know genetic risk for CRC. 
        • A personal history of getting radiation to the abdomen or pelvic area to treat prior cancer. 
        • Personal history of inflammatory bowel disease (Ulcerative Colitis or Crohn’s disease). 

        Clinical Utility

        The clinical utility of this panel is:  
         
        • The genetic and molecular diagnosis for an accurate clinical diagnosis of a patient with personal or family history suggestive of a hereditary cancer syndrome.  
        • Early initiation of treatment with a multidisciplinary team for appropriate total body screening, early surgical intervention, or pharmacologic treatment.  
        • Risk assessment of asymptomatic family members according to the mode of inheritance  
        • Reduce the incidence of advanced adenomas at colonoscopy. 
        • Prevention of CRC. 
        • Reduce morbidity related to CRC, or morbidity secondary to complications of surveillance and treatment. 
        • Improved identification of hereditary CRC syndromes. 
        • Improved pathways from diagnosis to treatment in susceptible populations. 

        Genes & Diseases

        See all genes and diseases

        GENE 

        OMIM DISEASES 

        INHERITANCE* 

        % GENE COVERAGE (20X) 

        HGMD** 

        AKT1 

        Cowden Syndrome 6 

        AD 

        100 

        6 of 6 

        APC 

        Familial Adenomatous Polyposis 1, Desmoid Disease, Gardner Syndrome 

        AD 

        98.92 

        1846 of 1882 

        AXIN2 

        AXIN2-Related Attenuated Familial Adenomatous Polyposis, Oligodontia-Colorectal Cancer Syndrome 

        AD 

        99.86 

        1608 of 1632 

        ATM 

        Ataxia-Telangiectasia, Breast Cancer, Mantle Cell Lymphoma 

        AD.AR 

        99.93 

        32 of 33 

        BLM 

        Bloom Syndrome 

        AR 

        97.19 

        133 of 141 

        BMPR1A 

        Familial Colorectal Cancer Type X, Juvenile Polyposis Syndrome Of Infancy, Polyposis Syndrome Juvenile Intestinal, Polyposis Syndrome Hereditary Mixed  

        AD 

        100 

        124 of 127 

        BUB1B 

        Mosaic Variegated Aneuploidy Syndrome 

        AD, AR 

        99.84 

        30 of 31 

        CDH1 

        Blepharo-Cheilo-Odontic Syndrome, Breast Cancer, Cleft Lip/Palate, Gastric Cancer, Prostate Cancer 

        AD 

        100 

        361 of 363 

        CHEK2 

        Li-Fraumeni Syndrome, Breast Cancer Susceptibility To, Prostate Cancer Susceptibility To, Colorectal Cancer Susceptibility To 

        AD 

        99.47 

        307 of 310 

        ENG 

        Familial Cerebral Saccular Aneurysm, Generalized Juvenile Polyposis/Juvenile Polyposis Coli, Hereditary Haemorrhagic Telangiectasia 

        AD 

        100 

        467 of 471 

        EPCAM 

        Colorectal Cancer, Hereditary Nonpolyposis, Type 8, Lynch Syndrome 

        AR 

        99.94 

        52 of 70 

        FLCN 

        Birt–Hogg–Dubé Syndrome, Colorectal Cancer, Renal Cell Carcinoma Nonpapillary 

        AD 

        100 

        200 of 205 

        GALNT12 

        Colorectal Cancer, Susceptibility To, 1 

         

        88.97 

        14 of 15 

        GREM1 

        Hereditary Mixed Polyposis Syndrome 

         

        99.89 

        5 of 5 

        MLH1 

        Colorectal Cancer, Hereditary Nonpolyposis, Type 2, Lynch Syndrome, Mismatch Repair Cancer Syndrome, Muir–Torre Syndrome 

        AD, AR 

        99.94 

        1079 of 1118 

        MLH3 

        Colorectal Cancer, Hereditary Nonpolyposis, Type 7, Endometrial Carcinoma 

        AD 

        99.98 

        32 of 32 

        MSH2 

        Lynch Syndrome, Mismatch Repair Cancer Syndrome, Muir–Torre Syndrome 

        AD, AR 

        99.99 

        1032 of 1057 

        MSH3 

        Familial Adenomatous Polyposis 4 

        AD, AR 

        99.42 

        23 of 24 

        MSH6 

        Colorectal Cancer, Hereditary Nonpolyposis, Type 5, Lynch Syndrome, Mismatch Repair Cancer Syndrome, Muir-Torre Syndrome 

        AD, AR 

        99.28 

        613 of 641 

        MUTYH 

        Familial Adenomatous Polyposis, 2 

        AR 

        100 

        183 of 183 

        NTHL1 

        Familial Adenomatous Polyposis 3 

        AR 

        100 

        13 of 13 

        PIK3CA 

        Cowden Syndrome 5 

        AD 

        99.58 

        54 of 58 

        PMS2 

        Colorectal Cancer, Hereditary Nonpolyposis, Type 4, Lynch Syndrome, Mismatch Repair Cancer Syndrome 

        AD, AR 

        97.17 

        264 of 285 

        POLD1 

        Colorectal Cancer, Susceptibility To, 10, Mandibular Hypoplasia, Deafness, Progeroid Features, And Lipodystrophy Syndrome, Polymerase Proofreading-Related Adenomatous Polyposis 

        AD 

        100 

        40 of 41 

        POLE 

        Colorectal Cancer, Susceptibility To, 12, FILS Syndrome, IMAGE-I Syndrome, Polymerase Proofreading-Related Adenomatous Polyposis 

        AD, AR 

        100 

        100 of 100 

        PTEN 

        Bannayan-Riley-Ruvalcaba Syndrome, Cowden Syndrome, Hereditary Breast And Ovarian Cancer Syndrome, Juvenile Polyposis Of Infancy, Lhermitte-Duclos Disease, Meningioma, Familial, Susceptibility To, Proteus Syndrome, Proteus-Like Syndrome, Segmental Outgrowth-Lipomatosis-Arteriovenous Malformation-Epidermal Nevus Syndrome 

        AD 

        99.97 

        609 of 629 

        RNF43 

        Sessile Serrated Polyposis Cancer Syndrome 

        AD 

        99.98 

        13 of 13 

        RPS20 

        Familial Colorectal Cancer 

         

        99.97 

        1 of 1 

        SMAD4 

        Juvenile Polyposis/Hereditary Haemorrhagic Telangiectasia Syndrome, Polyposis, Juvenile Intestinal, Myhre Dysplasia, Polyposis, Juvenile Intestinal 

        AD 

        99.56 

        136 of 136 

        STK11 

        Peutz–Jeghers Syndrome 

        AD 

        81.99 

        456 of 470 

        TP53 

        Adrenocortical Carcinoma, Paediatric, Basal Cell Carcinoma, Susceptibility To, 7, Bone Marrow Failure Syndrome 5, Breast Cancer, Colorectal Cancer, Familial Pancreatic Carcinoma, Glioma Susceptibility 1, Hereditary Breast And Ovarian Cancer Syndrome, Li–Fraumeni Syndrome, Osteosarcoma, Papilloma Of Choroid Plexus 

        AD, MU 

        98.92 

        557 of 563 

        *Inheritance: AD: Autosomal Dominant; AR: Autosomal Recessive; X: X linked; XLR: X linked Recessive; Mi: Mitochondrial; Mu: Multifactorial.  

        **Number of clinically relevant mutations according to HGMD 

        Methodology

        References

        See scientific referrals

        Lorans M, Dow E, Macrae FA, Winship IM, Buchanan DD. Update on Hereditary Colorectal Cancer: Improving the Clinical Utility of Multigene Panel Testing. Clin Colorectal Cancer. 2018 Jun;17(2):e293-e305. doi: 10.1016/j.clcc.2018.01.001. 

        Guillén-Ponce C, Lastra E, Lorenzo-Lorenzo I, Martín Gómez T, Morales Chamorro R, Sánchez-Heras AB, Serrano R, Soriano Rodríguez MC, Soto JL, Robles L. SEOM clinical guideline on hereditary colorectal cancer (2019). Clin Transl Oncol. 2020 Feb;22(2):201-212. doi: 10.1007/s12094-019-02272-y.  

        National Comprehensive Cancer Network.  (2021). Retrieved from https://www.nccn.org/professionals/physician_gls/default.aspx#detection 

        American Cancer Society https://www.cancer.org/cancer/colon-rectal-cancer.html 

        Brosens, L. A., Offerhaus, G. J., & Giardiello, F. M. (2015). Hereditary Colorectal Cancer: Genetics and Screening. The Surgical clinics of North America, 95(5), 1067–1080. https://doi.org/10.1016/j.suc.2015.05.004 

        Stoffel, E. M., Mangu, P. B., Gruber, S. B., Hamilton, S. R., Kalady, M. F., Lau, M. W., Lu, K. H., Roach, N., Limburg, P. J., American Society of Clinical Oncology, & European Society of Clinical Oncology (2015). Hereditary colorectal cancer syndromes: American Society of Clinical Oncology Clinical Practice Guideline endorsement of the familial risk-colorectal cancer: European Society for Medical Oncology Clinical Practice Guidelines. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 33(2), 209–217. https://doi.org/10.1200/JCO.2014.58.1322 

        Giardiello, F. M., Allen, J. I., Axilbund, J. E., Boland, C. R., Burke, C. A., Burt, R. W., Church, J. M., Dominitz, J. A., Johnson, D. A., Kaltenbach, T., Levin, T. R., Lieberman, D. A., Robertson, D. J., Syngal, S., Rex, D. K., & US Multi-Society Task Force on Colorectal Cancer (2014). Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-Society Task Force on colorectal cancer. Gastroenterology, 147(2), 502–526. https://doi.org/10.1053/j.gastro.2014.04.001 

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