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2014 ; 13
(3
): 369-74
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Fertility and apparent genetic anticipation in Lynch syndrome
#MMPMID24677027
Stupart D
; Win AK
; Jenkins M
; Winship IM
; Goldberg P
; Ramesar R
Fam Cancer
2014[Sep]; 13
(3
): 369-74
PMID24677027
show ga
Genetic anticipation is the phenomenon in which age of onset of an inherited
disorder decreases in successive generations. Inconsistent evidence suggests that
this occurs in Lynch syndrome. A possible cause for apparent anticipation is
fecundity bias, which occurs if the disease adversely affects fertility. The
purpose of this study was to determine the effect of age of diagnosis of
colorectal cancer (CRC) on lifetime fertility in Lynch syndrome, and whether this
can falsely create the appearance of genetic anticipation. A computer model
simulated age of diagnosis of CRC in hypothetical Lynch syndrome carriers and
their offspring. The model assumed similar age distribution of CRC across
generations (i.e. that there was no true anticipation). Age distribution of CRC
diagnosis, and lifetime fertility rates (grouped by age of diagnosis of CRC) were
determined from the Australasian Colorectal Cancer Family Registry (ACCFR).
Apparent anticipation was calculated by comparing ages of diagnosis of CRC in
affected parent-child pairs. A total of 1,088 patients with CRC were identified
from the ACCFR. Total lifetime (cohort) fertility was related to age of diagnosis
of CRC (correlation coefficient 0.13, P = 0.0001). In the simulation, apparent
anticipation was 1.8 ± 0.54 years (P = 0.0044). Observed apparent anticipation in
the ACCFR cohort was 4.8 ± 1.73 years (P = 0.0064). There was no difference in
apparent anticipation between the simulate d and observed parent-child pairs
(P = 0.89). The appearance of genetic anticipation in Lynch syndrome can be
falsely created due to changes in fertility.