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    Does genetic predisposition modify the effect of lifestyle-related factors on DNA methylation?
    Yu, C ; Hodge, AM ; Wong, EM ; Joo, JE ; Makalic, E ; Schmidt, DF ; Buchanan, DD ; Severi, G ; Hopper, JL ; English, DR ; Giles, GG ; Milne, RL ; Southey, MC ; Dugue, P-A (TAYLOR & FRANCIS INC, 2022-12-02)
    Lifestyle-related phenotypes have been shown to be heritable and associated with DNA methylation. We aimed to investigate whether genetic predisposition to tobacco smoking, alcohol consumption, and higher body mass index (BMI) moderates the effect of these phenotypes on blood DNA methylation. We calculated polygenic scores (PGS) to quantify genetic predisposition to these phenotypes using training (N = 7,431) and validation (N = 4,307) samples. Using paired genetic-methylation data (N = 4,307), gene-environment interactions (i.e., PGS × lifestyle) were assessed using linear mixed-effects models with outcomes: 1) methylation at sites found to be strongly associated with smoking (1,061 CpGs), alcohol consumption (459 CpGs), and BMI (85 CpGs) and 2) two epigenetic ageing measures, PhenoAge and GrimAge. In the validation sample, PGS explained ~1.4% (P = 1 × 10-14), ~0.6% (P = 2 × 10-7), and ~8.7% (P = 7 × 10-87) of variance in smoking initiation, alcohol consumption, and BMI, respectively. Nominally significant interaction effects (P < 0.05) were found at 61, 14, and 7 CpGs for smoking, alcohol consumption, and BMI, respectively. There was strong evidence that all lifestyle-related phenotypes were positively associated with PhenoAge and GrimAge, except for alcohol consumption with PhenoAge. There was weak evidence that the association of smoking with GrimAge was attenuated in participants genetically predisposed to smoking (interaction term: -0.022, standard error [SE] = 0.012, P = 0.058) and that the association of alcohol consumption with PhenoAge was attenuated in those genetically predisposed to drink alcohol (interaction term: -0.030, SE = 0.015, P = 0.041). In conclusion, genetic susceptibility to unhealthy lifestyles did not strongly modify the association between observed lifestyle behaviour and blood DNA methylation. Potential associations were observed for epigenetic ageing measures, which should be replicated in additional studies.
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    Methylation scores for smoking, alcohol consumption and body mass index and risk of seven types of cancer
    Dugue, P-A ; Yu, C ; Hodge, AMM ; Wong, EM ; Joo, JEE ; Jung, C-H ; Schmidt, D ; Makalic, E ; Buchanan, DDD ; Severi, G ; English, DRR ; Hopper, JLL ; Milne, RLL ; Giles, GGG ; Southey, MCC (WILEY, 2023-08-01)
    Methylation marks of exposure to health risk factors may be useful markers of cancer risk as they might better capture current and past exposures than questionnaires, and reflect different individual responses to exposure. We used data from seven case-control studies nested within the Melbourne Collaborative Cohort Study of blood DNA methylation and risk of colorectal, gastric, kidney, lung, prostate and urothelial cancer, and B-cell lymphoma (N cases = 3123). Methylation scores (MS) for smoking, body mass index (BMI), and alcohol consumption were calculated based on published data as weighted averages of methylation values. Rate ratios (RR) and 95% confidence intervals for association with cancer risk were estimated using conditional logistic regression and expressed per SD increase of the MS, with and without adjustment for health-related confounders. The contribution of MS to discriminate cases from controls was evaluated using the area under the curve (AUC). After confounder adjustment, we observed: large associations (RR = 1.5-1.7) with lung cancer risk for smoking MS; moderate associations (RR = 1.2-1.3) with urothelial cancer risk for smoking MS and with mature B-cell neoplasm risk for BMI and alcohol MS; moderate to small associations (RR = 1.1-1.2) for BMI and alcohol MS with several cancer types and cancer overall. Generally small AUC increases were observed after inclusion of several MS in the same model (colorectal, gastric, kidney, urothelial cancers: +3%; lung cancer: +7%; B-cell neoplasms: +8%). Methylation scores for smoking, BMI and alcohol consumption show independent associations with cancer risk, and may provide some improvements in risk prediction.
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    Methylation-based markers of aging and lifestyle-related factors and risk of breast cancer: a pooled analysis of four prospective studies
    Dugue, P-A ; Bodelon, C ; Chung, FF ; Brewer, HR ; Ambatipudi, S ; Sampson, JN ; Cuenin, C ; Chajes, V ; Romieu, I ; Fiorito, G ; Sacerdote, C ; Krogh, V ; Panico, S ; Tumino, R ; Vineis, P ; Polidoro, S ; Baglietto, L ; English, D ; Severi, G ; Giles, GG ; Milne, RL ; Herceg, Z ; Garcia-Closas, M ; Flanagan, JM ; Southey, MC (BMC, 2022-09-06)
    BACKGROUND: DNA methylation in blood may reflect adverse exposures accumulated over the lifetime and could therefore provide potential improvements in the prediction of cancer risk. A substantial body of research has shown associations between epigenetic aging and risk of disease, including cancer. Here we aimed to study epigenetic measures of aging and lifestyle-related factors in association with risk of breast cancer. METHODS: Using data from four prospective case-control studies nested in three cohorts of European ancestry participants, including a total of 1,655 breast cancer cases, we calculated three methylation-based measures of lifestyle factors (body mass index [BMI], tobacco smoking and alcohol consumption) and seven measures of epigenetic aging (Horvath-based, Hannum-based, PhenoAge and GrimAge). All measures were regression-adjusted for their respective risk factors and expressed per standard deviation (SD). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional or unconditional logistic regression and pooled using fixed-effects meta-analysis. Subgroup analyses were conducted by age at blood draw, time from blood sample to diagnosis, oestrogen receptor-positivity status and tumour stage. RESULTS: None of the measures of epigenetic aging were associated with risk of breast cancer in the pooled analysis: Horvath 'age acceleration' (AA): OR per SD = 1.02, 95%CI: 0.95-1.10; AA-Hannum: OR = 1.03, 95%CI:0.95-1.12; PhenoAge: OR = 1.01, 95%CI: 0.94-1.09 and GrimAge: OR = 1.03, 95%CI: 0.94-1.12, in models adjusting for white blood cell proportions, body mass index, smoking and alcohol consumption. The BMI-adjusted predictor of BMI was associated with breast cancer risk, OR per SD = 1.09, 95%CI: 1.01-1.17. The results for the alcohol and smoking methylation-based predictors were consistent with a null association. Risk did not appear to substantially vary by age at blood draw, time to diagnosis or tumour characteristics. CONCLUSION: We found no evidence that methylation-based measures of aging, smoking or alcohol consumption were associated with risk of breast cancer. A methylation-based marker of BMI was associated with risk and may provide insights into the underlying associations between BMI and breast cancer.
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    Epigenetic mechanisms of lung carcinogenesis involve differentially methylated CpG sites beyond those associated with smoking
    Petrovic, D ; Bodinier, B ; Dagnino, S ; Whitaker, M ; Karimi, M ; Campanella, G ; Haugdahl Nost, T ; Polidoro, S ; Palli, D ; Krogh, V ; Tumino, R ; Sacerdote, C ; Panico, S ; Lund, E ; Dugue, P-A ; Giles, GG ; Severi, G ; Southey, M ; Vineis, P ; Stringhini, S ; Bochud, M ; Sandanger, TM ; Vermeulen, RCH ; Guida, F ; Chadeau-Hyam, M (SPRINGER, 2022-06)
    Smoking-related epigenetic changes have been linked to lung cancer, but the contribution of epigenetic alterations unrelated to smoking remains unclear. We sought for a sparse set of CpG sites predicting lung cancer and explored the role of smoking in these associations. We analysed CpGs in relation to lung cancer in participants from two nested case-control studies, using (LASSO)-penalised regression. We accounted for the effects of smoking using known smoking-related CpGs, and through conditional-independence network. We identified 29 CpGs (8 smoking-related, 21 smoking-unrelated) associated with lung cancer. Models additionally adjusted for Comprehensive Smoking Index-(CSI) selected 1 smoking-related and 49 smoking-unrelated CpGs. Selected CpGs yielded excellent discriminatory performances, outperforming information provided by CSI only. Of the 8 selected smoking-related CpGs, two captured lung cancer-relevant effects of smoking that were missed by CSI. Further, the 50 CpGs identified in the CSI-adjusted model complementarily explained lung cancer risk. These markers may provide further insight into lung cancer carcinogenesis and help improving early identification of high-risk patients.
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    Alcohol consumption is associated with widespread changes in blood DNA methylation: Analysis of cross-sectional and longitudinal data
    Dugue, P-A ; Wilson, R ; Lehne, B ; Jayasekara, H ; Wang, X ; Jung, C-H ; Joo, JE ; Makalic, E ; Schmidt, DF ; Baglietto, L ; Severi, G ; Gieger, C ; Ladwig, K-H ; Peters, A ; Kooner, JS ; Southey, MC ; English, DR ; Waldenberger, M ; Chambers, JC ; Giles, GG ; Milne, RL (WILEY, 2021-01)
    DNA methylation may be one of the mechanisms by which alcohol consumption is associated with the risk of disease. We conducted a large-scale, cross-sectional, genome-wide DNA methylation association study of alcohol consumption and a longitudinal analysis of repeated measurements taken several years apart. Using the Illumina HumanMethylation450 BeadChip, DNA methylation was measured in blood samples from 5606 Melbourne Collaborative Cohort Study (MCCS) participants. For 1088 of them, these measures were repeated using blood samples collected a median of 11 years later. Associations between alcohol intake and blood DNA methylation were assessed using linear mixed-effects regression models. Independent data from the London Life Sciences Prospective Population (LOLIPOP) (N = 4042) and Cooperative Health Research in the Augsburg Region (KORA) (N = 1662) cohorts were used to replicate associations discovered in the MCCS. Cross-sectional analyses identified 1414 CpGs associated with alcohol intake at P < 10-7 , 1243 of which had not been reported previously. Of these novel associations, 1078 were replicated (P < .05) using LOLIPOP and KORA data. Using the MCCS data, we also replicated 403 of 518 previously reported associations. Interaction analyses suggested that associations were stronger for women, non-smokers, and participants genetically predisposed to consume less alcohol. Of the 1414 CpGs, 530 were differentially methylated (P < .05) in former compared with current drinkers. Longitudinal associations between the change in alcohol intake and the change in methylation were observed for 513 of the 1414 cross-sectional associations. Our study indicates that alcohol intake is associated with widespread changes in DNA methylation across the genome. Longitudinal analyses showed that the methylation status of alcohol-associated CpGs may change with alcohol consumption changes in adulthood.
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    Epigenetic Drift Association with Cancer Risk and Survival, and Modification by Sex
    Yu, C ; Wong, EM ; Joo, JE ; Hodge, AM ; Makalic, E ; Schmidt, D ; Buchanan, DD ; Severi, G ; Hopper, JL ; English, DR ; Giles, GG ; Southey, MC ; Dugue, P-A (MDPI, 2021-04)
    To investigate age- and sex-specific DNA methylation alterations related to cancer risk and survival, we used matched case-control studies of colorectal (n = 835), gastric (n = 170), kidney (n = 143), lung (n = 332), prostate (n = 869) and urothelial (n = 428) cancers, and mature B-cell lymphoma (n = 438). Linear mixed-effects models were conducted to identify age-, sex- and age-by-sex-associated methylation markers using a discovery (controls)-replication (cases) strategy. Replication was further examined using summary statistics from Generation Scotland (GS). Associations between replicated markers and risk of and survival from cancer were assessed using conditional logistic regression and Cox models (hazard ratios (HR)), respectively. We found 32,659, 23,141 and 48 CpGs with replicated associations for age, sex and age-by-sex, respectively. The replication rates for these CpGs using GS summary data were 94%, 86% and 91%, respectively. Significant associations for cancer risk and survival were identified at some individual age-related CpGs. Opposite to previous findings using epigenetic clocks, there was a strong negative trend in the association between epigenetic drift and risk of colorectal cancer. Methylation at two CpGs overlapping TMEM49 and ARX genes was associated with survival of overall (HR = 0.91, p = 7.7 × 10-4) and colorectal (HR = 1.52, p = 1.8 × 10-4) cancer, respectively, with significant age-by-sex interaction. Our results may provide markers for cancer early detection and prognosis prediction.
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    Rare germline genetic variants and risk of aggressive prostate cancer
    Nguyen-Dumont, T ; MacInnis, RJ ; Steen, JA ; Theys, D ; Tsimiklis, H ; Hammet, F ; Mahmoodi, M ; Pope, BJ ; Park, DJ ; Mahmood, K ; Severi, G ; Bolton, D ; Milne, RL ; Giles, GG ; Southey, MC (WILEY, 2020-10-15)
    Few genetic risk factors have been demonstrated to be specifically associated with aggressive prostate cancer (PrCa). Here, we report a case-case study of PrCa comparing the prevalence of germline pathogenic/likely pathogenic (P/LP) genetic variants in 787 men with aggressive disease and 769 with nonaggressive disease. Overall, we observed P/LP variants in 11.4% of men with aggressive PrCa and 9.8% of men with nonaggressive PrCa (two-tailed Fisher's exact tests, P = .28). The proportion of BRCA2 and ATM P/LP variant carriers in men with aggressive PrCa exceeded that observed in men with nonaggressive PrCa; 18/787 carriers (2.3%) and 4/769 carriers (0.5%), P = .004, and 14/787 carriers (0.02%) and 5/769 carriers (0.01%), P = .06, respectively. Our findings contribute to the extensive international effort to interpret the genetic variation identified in genes included on gene-panel tests, for which there is currently an insufficient evidence-base for clinical translation in the context of PrCa risk.
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    Rare Germline Pathogenic Variants Identified by Multigene Panel Testing and the Risk of Aggressive Prostate Cancer
    Nguyen-Dumont, T ; Dowty, JG ; MacInnis, RJ ; Steen, JA ; Riaz, M ; Dugue, P-A ; Renault, A-L ; Hammet, F ; Mahmoodi, M ; Theys, D ; Tsimiklis, H ; Severi, G ; Bolton, D ; Lacaze, P ; Sebra, R ; Schadt, E ; McNeil, J ; Giles, GG ; Milne, RL ; Southey, MC (MDPI, 2021-04)
    While gene panel sequencing is becoming widely used for cancer risk prediction, its clinical utility with respect to predicting aggressive prostate cancer (PrCa) is limited by our current understanding of the genetic risk factors associated with predisposition to this potentially lethal disease phenotype. This study included 837 men diagnosed with aggressive PrCa and 7261 controls (unaffected men and men who did not meet criteria for aggressive PrCa). Rare germline pathogenic variants (including likely pathogenic variants) were identified by targeted sequencing of 26 known or putative cancer predisposition genes. We found that 85 (10%) men with aggressive PrCa and 265 (4%) controls carried a pathogenic variant (p < 0.0001). Aggressive PrCa odds ratios (ORs) were estimated using unconditional logistic regression. Increased risk of aggressive PrCa (OR (95% confidence interval)) was identified for pathogenic variants in BRCA2 (5.8 (2.7-12.4)), BRCA1 (5.5 (1.8-16.6)), and ATM (3.8 (1.6-9.1)). Our study provides further evidence that rare germline pathogenic variants in these genes are associated with increased risk of this aggressive, clinically relevant subset of PrCa. These rare genetic variants could be incorporated into risk prediction models to improve their precision to identify men at highest risk of aggressive prostate cancer and be used to identify men with newly diagnosed prostate cancer who require urgent treatment.
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    Cumulative Burden of Colorectal Cancer Associated Genetic Variants Is More Strongly Associated With Early-Onset vs Late-Onset Cancer
    Archambault, AN ; Su, Y-R ; Jeon, J ; Thomas, M ; Lin, Y ; Conti, DV ; Win, AK ; Sakoda, LC ; Lansdorp-Vogelaar, I ; Peterse, EFP ; Zauber, AG ; Duggan, D ; Holowatyj, AN ; Huyghe, JR ; Brenner, H ; Cotterchio, M ; Bezieau, S ; Schmit, SL ; Edlund, CK ; Southey, MC ; MacInnis, RJ ; Campbell, PT ; Chang-Claude, J ; Slattery, ML ; Chan, AT ; Joshi, AD ; Song, M ; Cao, Y ; Woods, MO ; White, E ; Weinstein, SJ ; Ulrich, CM ; Hoffmeister, M ; Bien, SA ; Harrison, TA ; Hampe, J ; Li, CI ; Schafmayer, C ; Offit, K ; Pharoah, PD ; Moreno, V ; Lindblom, A ; Wolk, A ; Wu, AH ; Li, L ; Gunter, MJ ; Gsur, A ; Keku, TO ; Pearlman, R ; Bishop, DT ; Castellvi-Bel, S ; Moreira, L ; Vodicka, P ; Kampman, E ; Giles, GG ; Albanes, D ; Baron, JA ; Berndt, SI ; Brezina, S ; Buch, S ; Buchanan, DD ; Trichopoulou, A ; Severi, G ; Chirlaque, M-D ; Sanchez, M-J ; Palli, D ; Kuhn, T ; Murphy, N ; Cross, AJ ; Burnett-Hartman, AN ; Chanock, SJ ; de la Chapelle, A ; Easton, DF ; Elliott, F ; English, DR ; Feskens, EJM ; FitzGerald, LM ; Goodman, PJ ; Hopper, JL ; Hudson, TJ ; Hunter, DJ ; Jacobs, EJ ; Joshu, CE ; Kury, S ; Markowitz, SD ; Milne, RL ; Platz, EA ; Rennert, G ; Rennert, HS ; Schumacher, FR ; Sandler, RS ; Seminara, D ; Tangen, CM ; Thibodeau, SN ; Toland, AE ; van Duijnhoven, FJB ; Visvanathan, K ; Vodickova, L ; Potter, JD ; Mannisto, S ; Weigl, K ; Figueiredo, J ; Martin, V ; Larsson, SC ; Parfrey, PS ; Huang, W-Y ; Lenz, H-J ; Castelao, JE ; Gago-Dominguez, M ; Munoz-Garzon, V ; Mancao, C ; Haiman, CA ; Wilkens, LR ; Siegel, E ; Barry, E ; Younghusband, B ; Van Guelpen, B ; Harlid, S ; Zeleniuch-Jacquotte, A ; Liang, PS ; Du, M ; Casey, G ; Lindor, NM ; Le Marchand, L ; Gallinger, SJ ; Jenkins, MA ; Newcomb, PA ; Gruber, SB ; Schoen, RE ; Hampel, H ; Corley, DA ; Hsu, L ; Peters, U ; Hayes, RB (W B SAUNDERS CO-ELSEVIER INC, 2020-04)
    BACKGROUND & AIMS: Early-onset colorectal cancer (CRC, in persons younger than 50 years old) is increasing in incidence; yet, in the absence of a family history of CRC, this population lacks harmonized recommendations for prevention. We aimed to determine whether a polygenic risk score (PRS) developed from 95 CRC-associated common genetic risk variants was associated with risk for early-onset CRC. METHODS: We studied risk for CRC associated with a weighted PRS in 12,197 participants younger than 50 years old vs 95,865 participants 50 years or older. PRS was calculated based on single nucleotide polymorphisms associated with CRC in a large-scale genome-wide association study as of January 2019. Participants were pooled from 3 large consortia that provided clinical and genotyping data: the Colon Cancer Family Registry, the Colorectal Transdisciplinary Study, and the Genetics and Epidemiology of Colorectal Cancer Consortium and were all of genetically defined European descent. Findings were replicated in an independent cohort of 72,573 participants. RESULTS: Overall associations with CRC per standard deviation of PRS were significant for early-onset cancer, and were stronger compared with late-onset cancer (P for interaction = .01); when we compared the highest PRS quartile with the lowest, risk increased 3.7-fold for early-onset CRC (95% CI 3.28-4.24) vs 2.9-fold for late-onset CRC (95% CI 2.80-3.04). This association was strongest for participants without a first-degree family history of CRC (P for interaction = 5.61 × 10-5). When we compared the highest with the lowest quartiles in this group, risk increased 4.3-fold for early-onset CRC (95% CI 3.61-5.01) vs 2.9-fold for late-onset CRC (95% CI 2.70-3.00). Sensitivity analyses were consistent with these findings. CONCLUSIONS: In an analysis of associations with CRC per standard deviation of PRS, we found the cumulative burden of CRC-associated common genetic variants to associate with early-onset cancer, and to be more strongly associated with early-onset than late-onset cancer, particularly in the absence of CRC family history. Analyses of PRS, along with environmental and lifestyle risk factors, might identify younger individuals who would benefit from preventive measures.