title: Common variants modify the age of onset for basal cell carcinomas in Gorlin syndrome.
abstract: Gorlin syndrome is an autosomal dominant disorder, characterized by multiple early-onset basal cell carcinomas (BCCs) and jaw keratocysts. Through association studies in cohorts of sporadic BCC, nine genetic variants have previously been identified to increase the risk of BCC. The nine SNPs were genotyped by Taqman allelic discrimination in 125 individuals with Gorlin syndrome. Kaplan-Meier survival curves and Cox proportional-Hazard regression analysis were applied to determine the association between genotypes and age of first BCC in individuals with Gorlin syndrome. The p.(Arg151Cys) variant in MC1R (rs1805007) was associated with an earlier median age of onset of BCC of 27 years (95% CI: 20-34) compared with 34 years (95% CI: 30-40) for wild-type individuals (hazard ratio (HR)=1.64, 95% CI: 1.04-2.58, P=0.034). The risk allele of the variant at the chromosome 5p15 locus encompassing TERT-CLPTM1L (rs401681) was also associated with an earlier median onset of BCC, 31 years (95% CI: 28-37) compared with 41 years (95% CI: 32-48, HR=1.44, 95% CI: 1.08-1.93, P=0.014). In individuals with a risk allele at either rs1805007 or rs401681 the median time to BCC was 31 years of age (95% CI: 28-34) compared with 44 years of age (95% CI: 38-53) in wild-type individuals (HR=2.48, 95% CI: 1.47-4.17, P=0.0002). Our findings may have implications for future personalized risk estimates and BCC screening strategies in individuals with Gorlin syndrome.
authors.affiliation: 1] Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK [2] Department of Genetic Medicine, Manchester Centre for Genomic Medicine, MAHSC, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust (CMFT), Manchester, UK.
authors.forename: Binnaz
authors.initials: B
authors.lastname: Yasar
authors.affiliation: 1] Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK [2] Department of Genetic Medicine, Manchester Centre for Genomic Medicine, MAHSC, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust (CMFT), Manchester, UK.
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Byers
authors.affiliation: 1] Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK [2] Department of Genetic Medicine, Manchester Centre for Genomic Medicine, MAHSC, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust (CMFT), Manchester, UK.
authors.forename: Miriam J
authors.initials: MJ
authors.lastname: Smith
authors.affiliation: Department of Dermatology, Central Manchester University Hospitals NHS Foundation Trust (CMFT), Manchester, UK.
authors.forename: John
authors.initials: J
authors.lastname: Lear
authors.affiliation: Department of Surgery, The Christie NHS Foundation Trust, MAHSC, Manchester, UK.
authors.forename: Deemesh
authors.initials: D
authors.lastname: Oudit
authors.affiliation: Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK.
authors.forename: Zaynab
authors.initials: Z
authors.lastname: Bholah
authors.affiliation: Centre for Biostatistics, Institute of Population Health, University of Manchester, Manchester, UK.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Roberts
authors.affiliation: 1] Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK [2] Department of Genetic Medicine, Manchester Centre for Genomic Medicine, MAHSC, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust (CMFT), Manchester, UK.
authors.forename: William G
authors.initials: WG
authors.lastname: Newman
authors.affiliation: 1] Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK [2] Department of Genetic Medicine, Manchester Centre for Genomic Medicine, MAHSC, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust (CMFT), Manchester, UK.
authors.forename: D Gareth
authors.initials: DG
authors.lastname: Evans
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D001478:Basal Cell Nevus Syndrome / Q000453:epidemiology* / Q000235:genetics* / Q000401:mortality; D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D020641:Polymorphism, Single Nucleotide; D055815:Young Adult