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A Molecular Variant of the APC Gene at Codon 1822: Its Association with Diet, Lifestyle, and Risk of Colon Cancer¹

Departments of Family and Preventive Medicine [M. L. S.], Pathology [W. S.], and Genetics [M. L.] and Genomics Core Facility [L. B.], University of Utah, Salt Lake City, Utah 84112; Kaiser Permanente Medical Care Program, Oakland, California 94611 [D. S.]; and Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024 [J. D. P.]

The adenomatous polyposis coli (APC) gene is important in the etiology of colon cancer. Although germ-line mutations of this gene rarely occur in the population, less penetrant variants of the gene have been reported. One variant, producing an aspartate to valine change at codon 1822 (B1822V) has been previously reported as having an allele frequency of 10%. The purpose of this study was to determine whether this B1822V variant of the APC gene is associated with colon cancer and whether its association is influenced by other genetic or environmental factors. We used data collected as part of a multicenter study of 1585 incident cases of colon cancer and 1945 age- and sex-matched population-based controls to evaluate genetic, dietary, and environmental associations with the B1822V variant of the APC gene. The frequency of the valine/valine allele at codon 1822 was 22.8% in this population. In the control population, 61.5% were homozygote wild type, 33.3% were heterozygotes, and 5.2% were homozygote variant. Cases were slightly less likely to have the homozygous variant APC genotype than were controls [odds ratio (OR), 0.8; 95% confidence interval (CI), 0.6–1.1]; for those diagnosed after age 65, the homozygous APC variant was associated with reduced risk of colon cancer (OR, 0.6; 95% CI, 0.4–1.0). Assessment of the homozygous APC variant with dietary, genetic, and environmental factors showed that individuals with this genotype were at lower risk if they consumed a low-fat diet (OR, 0.2; 95% CI, 0.1–0.5) relative to those who were homozygous wild type and ate a high-fat diet. This finding was specific to a low-fat diet and was unrelated to other dietary variables. These results suggest that the codon 1822 variant of the APC gene may have functional significance. Individuals who have the valine/valine variant of this gene may be at reduced risk of colon cancer if they eat a low-fat diet.

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