Abstract
Multigene panel testing for cancer predisposition mutations is becoming routine in clinical care. However, the gene content of panels offered by testing laboratories vary significantly, and data on mutation detection rates by gene and by the panel is limited, causing confusion among clinicians on which test to order. Using results from 147,994 multigene panel tests conducted at Ambry Genetics, we built an interactive prevalence tool to explore how differences in ethnicity, age of onset, and personal and family history of different cancers affect the prevalence of pathogenic mutations in 31 cancer predisposition genes, across various clinically available hereditary cancer gene panels. Over 13,000 mutation carriers were identified in this high‐risk population. Most were non‐Hispanic white (74%, n = 109,537), but also Black (n = 10,875), Ashkenazi Jewish (n = 10,464), Hispanic (n = 10,028), and Asian (n = 7,090). The most prevalent cancer types were breast (50%), ovarian (6.6%), and colorectal (4.7%), which is expected based on genetic testing guidelines and clinician referral for testing. The Hereditary Cancer Multi‐Gene Panel Prevalence Tool presented here can be used to provide insight into the prevalence of mutations on a per‐gene and per‐multigene panel basis, while conditioning on multiple custom phenotypic variables to include race and cancer type.
Highlights
Between 5-10% of all cancers are associated with an inherited mutation in a cancer predisposition gene
Using results from approximately 150,000 multi-gene panel tests conducted at Ambry Genetics, we built an interactive prevalence tool to explore how differences in ethnicity, age of onset, and personal and family history of different cancers affect the prevalence of pathogenic mutations in 31 cancer predisposition genes, across various clinically available hereditary cancer gene panels
Most of the cases were Non-Hispanic White (74%, n=109,537), and provide an appreciable dataset for those identifying as Black (n=10,875), Ashkenazi Jewish (n=10,464), Hispanic (n=10,028), and Asian (n=7,090)
Summary
Between 5-10% of all cancers are associated with an inherited mutation in a cancer predisposition gene. In an attempt to provide some guidance into who should be tested for predisposition mutations, the National Comprehensive Cancer Network (NCCN) set out criteria to categorize individuals who are likely to contain a mutation in a predisposition gene - primarily based on an individual’s personal and family history of cancers. Pre-test probability models have been the gold standard to assess the likelihood that an individual is a mutation carrier in BRCA1/2. These include BOADICEA4,5, BRCAPRO6,7, the Myriad II8,9, IBIS10, Penn
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