Abstract

Simple SummaryThe French Canadian population of the province of Quebec has been investigated because of its genetic attributes and is known for making significant contributions to the medical genetics field. Their unique genetic background has been attributed to a small number of early settlers from France that contributed to the majority of the gene pool. The French Canadian population has been investigated for the role of known breast and ovarian cancer predisposing genes, such as BRCA1 and BRCA2. In this review we describe the merits of studying this population with respect to the discovery of new such cancer predisposing gene.The French Canadian population of the province of Quebec has been recognized for its contribution to research in medical genetics, especially in defining the role of heritable pathogenic variants in cancer predisposing genes. Multiple carriers of a limited number of pathogenic variants in BRCA1 and BRCA2, the major risk genes for hereditary breast and/or ovarian cancer syndrome families, have been identified in French Canadians, which is in stark contrast to the array of over 2000 different pathogenic variants reported in each of these genes in other populations. As not all such cancer syndrome families are explained by BRCA1 and BRCA2, newly proposed gene candidates identified in other populations have been investigated for their role in conferring risk in French Canadian cancer families. For example, multiple carriers of distinct variants were identified in PALB2 and RAD51D. The unique genetic architecture of French Canadians has been attributed to shared ancestry due to common ancestors of early settlers of this population with origins mainly from France. In this review, we discuss the merits of genetically characterizing cancer predisposing genes in French Canadians of Quebec. We focused on genes that have been implicated in hereditary breast and/or ovarian cancer syndrome families as they have been the most thoroughly characterized cancer syndromes in this population. We describe how genetic analyses of French Canadians have facilitated: (i) the classification of variants in BRCA1 and BRCA2; (ii) the identification and classification of variants in newly proposed breast and/or ovarian cancer predisposing genes; and (iii) the identification of a new breast cancer predisposing gene candidate, RECQL. The genetic architecture of French Canadians provides a unique opportunity to evaluate new candidate cancer predisposing genes regardless of the population in which they were identified.

Highlights

  • Over the past 40 years, genetic epidemiology studies of breast cancer (BC) and ovarian cancer (OC) have provided unequivocal evidence for the role of genetic factors conferring risk for these diseases

  • Unlike the high (1.1–2.5%) carrier frequency of the three founder BRCA1 and BRCA2 pathogenic variants (PVs) observed in the Ashkenazi Jewish population [75,76,77], there is no evidence to suggest that the overall BRCA-carrier frequency in French Canadian (FC) of Quebec is higher than 0.25% carrier frequency estimated for Northern Americans [78,79]

  • PVs that occur in the defined BC Cluster and OC Cluster Regions in BRCA1 and BRCA2 have been statistically associated with increased risk of BC, or OC, respectively [108]

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Summary

Introduction

Over the past 40 years, genetic epidemiology studies of breast cancer (BC) and ovarian cancer (OC) have provided unequivocal evidence for the role of genetic factors conferring risk for these diseases. The rarity of carriers of PVs in new risk genes and the genetic heterogeneity of HBC and HBOC syndromes likely explain the difficulty of both identifying and establishing the role of new cancer predisposing gene candidates. We posit that the unique genetic architecture of FCs of Quebec provides an opportunity to evaluate new candidate BC and OC predisposing genes (Appendix B) To elaborate upon this working hypothesis, we reviewed studies of FCs of Quebec that described rare variants (minor allele frequency ≤1% in the general population) in known and new candidate cancer predisposing genes that had been identified in the context of HBC and/or HBOC syndrome families consistent with an autosomal dominant mode of inheritance. We begin this review by summarizing the methods that have been successfully used to identify new BC and OC predisposing gene candidates

Methods
The Spectrum of BRCA1 and BRCA2 Variants in FCs
Genetic Analyses of FC Cancer Cases Helps Define the Role of New Candidate
A Predominant PV in PALB2 Frequently Occurs in FC Hereditary BC Cases
BRIP1 and CHEK2 in FC BC and OC Cases
The Role of Proposed Cancer Predisposing Genes in FCs
Perspectives
Findings
Conclusions
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