It has been shown that, for women aged 50 years or older, the discriminatory accuracy of the Breast Cancer Risk Prediction Tool (BCRAT) can be modestly improved by the inclusion of information on common single nucleotide polymorphisms (SNPs) that are associated with increased breast cancer risk. We aimed to determine whether a similar improvement is seen for earlier onset disease. We used the Australian Breast Cancer Family Registry to study a population-based sample of 962 cases aged 35 to 59 years and 463 controls frequency matched for age and for whom genotyping data was available. Overall, the inclusion of data on seven SNPs improved the area under the receiver operating characteristic curve (AUC) from 0.58 (95% confidence interval [CI]=0.55–0.61) for BCRAT alone to 0.61 (95% CI=0.58–0.64) for BCRAT and SNP data combined (p<0.001). For women aged 35 to 39 years at interview, the corresponding improvement in AUC was from 0.61 (95% CI=0.56–0.66) to 0.65 (95% CI=0.60–0.70; p=0.03), while for women aged 40 to 49 years at diagnosis, the AUC improved from 0.61 (95% CI=0.55–0.66) to 0.63 (95% CI=0.57–0.69; p=0.04). Using previously used classifications of low, intermediate and high risk, 2.1% of cases and none of the controls aged 35 to 39 years, and 10.9% of cases and 4.0% of controls aged 40 to 49 years were classified into a higher risk group. Including information on seven SNPs associated with breast cancer risk improves the discriminatory accuracy of BCRAT for women aged 35 to 39 years and 40 to 49 years. Given the low absolute risk for women in these age groups, only a small proportion are reclassified into a higher category for predicted 5-year risk of breast cancer.

VTRNA2-1 is a metastable epiallele with accumulating evidence that methylation at this region is heritable, modifiable and associated with disease including risk and progression of cancer. This study investigated the influence of genetic variation and other factors such as age and adult lifestyle on blood DNA methylation in this region. We first sequenced the VTRNA2-1 gene region in multiple-case breast cancer families in which VTRNA2-1 methylation was identified as heritable and associated with breast cancer risk. Methylation quantitative trait loci (mQTL) were investigated using a prospective cohort study (4500 participants with genotyping and methylation data). The cis-mQTL analysis (334 variants ± 50 kb of the most heritable CpG site) identified 43 variants associated with VTRNA2-1 methylation (p < 1.5 × 10−4); however, these explained little of the methylation variation (R2 < 0.5% for each of these variants). No genetic variants elsewhere in the genome were found to strongly influence VTRNA2-1 methylation. SNP-based heritability estimates were consistent with the mQTL findings (h2 = 0, 95%CI: −0.14 to 0.14). We found no evidence that age, sex, country of birth, smoking, body mass index, alcohol consumption or diet influenced blood DNA methylation at VTRNA2-1. Genetic factors and adult lifestyle play a minimal role in explaining methylation variability at the heritable VTRNA2-1 cluster.

Because of its geographic proximity to the major drug production centres, there is easy access to narcotic drugs in the Islamic Republic of Iran despite efforts by governmental and nongovernmental organizations. Using a structured questionnaire as a basis for conversation, local health workers interviewed 310 residents of a rural area in Babol province about opium use. The self-reported rate of opium use, adjusted due to a bias in the sex ratio of the sample, was 8.9%. All the 42 opium users reported opium use at least 2-3 times per week in the previous 3 months. Opium was smoked by 95.2% and taken orally by 4.8%; there was no injecting use. There was no reported use of other substances, including alcohol. There was a statistically significant relationship between opium use and male sex, unemployment and cigarette smoking. ‫اإلسالمية‬ ‫إيران‬ ‫مجهورية‬ ‫من‬ ‫الريفية‬ ‫املناطق‬ ‫يف‬ ‫األفيون‬ ‫تعاطي‬

BackgroundMassively parallel sequencing (MPS) has revolutionised biomedical research and offers enormous capacity for clinical application. We previously reported Hi-Plex, a streamlined highly-multiplexed PCR-MPS approach, allowing a given library to be sequenced with both the Ion Torrent and TruSeq chemistries. Comparable sequencing efficiency was achieved using material derived from lymphoblastoid cell lines and formalin-fixed paraffin-embedded tumour.MethodsHere, we report high-throughput application of Hi-Plex by performing blinded mutation screening of the coding regions of the breast cancer susceptibility gene PALB2 on a set of 95 blood-derived DNA samples that had previously been screened using Sanger sequencing and high-resolution melting curve analysis (n = 90), or genotyped by Taqman probe-based assays (n = 5). Hi-Plex libraries were prepared simultaneously using relatively inexpensive, readily available reagents in a simple half-day protocol followed by MPS on a single MiSeq run.ResultsWe observed that 99.93% of amplicons were represented at ≥10X coverage. All 56 previously identified variant calls were detected and no false positive calls were assigned. Four additional variant calls were made and confirmed upon re-analysis of previous data or subsequent Sanger sequencing.ConclusionsThese results support Hi-Plex as a powerful approach for rapid, cost-effective and accurate high-throughput mutation screening. They further demonstrate that Hi-Plex methods are suitable for and can meet the demands of high-throughput genetic testing in research and clinical settings.