The Role of Genetic Risk Factors in Keratinocyte Carcinoma Susceptibility

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Modified Project Summary/Abstract Section Keratinocyte carcinoma (KC), comprised of basal cell carcinoma and squamous cell carcinoma, is the most common malignancy in the United States, afflicting approximately 3 million Americans annually. The treatment of KCs is among the most costly of all cancers. Both basal cell carcinoma and squamous cell carcinoma derive from epidermal keratinocytes, but despite sharing the same cell of origin, these two keratinocyte carcinomas diverge along distinct oncogenic pathways. Risk factors for KCs include innate factors, such as genetic risk loci and fair pigmentation, and environmental exposures, including sun exposure, smoking, and immunosuppression. Recently, genetic association studies have begun to reveal specific genetic risk factors underlying KCs. However, there remains a gap in our understanding of which of these KC genetic risk loci affect the risk of KC in general and which affect susceptibility to basal cell carcinoma and squamous cell carcinoma specifically, how these loci are influenced by environmental exposures, and how these loci impact aggressive and high burden KCs. This study will determine whether KC genetic risk loci have effects that are specific to basal cell carcinoma or squamous cell carcinoma, or are shared across these two types of KC. We will further evaluate how environmental factors, including sun exposure, smoking, and immunosuppression influences these risks. Finally, we will develop a risk prediction model of high burden KCs, that builds on our recently developed risk prediction tool for squamous cell carcinoma, cSCCscore. This tool will improve our understanding of KC pathogenesis and help guide cancer screening decisions