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Teerlink CC, Albright FS, Lins L, Cannon-Albright LA. A comprehensive survey of cancer risks in extended families. Genet Med 2012; 14:107-14. [PMID: 22237439 DOI: 10.1038/gim.2011.2] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Cancer is familial; yet known cancer predisposition genes, as well as recognized environmental factors, explain only a small percentage of familial cancer clusters. This population-based description of cancer clustering describes patterns of cancer coaggregation suggestive of a genetic predisposition. METHODS Using a computerized genealogy of Utah families linked to a statewide cancer registry, we estimated the relative risks for 36 different cancer sites in first-, second-, and third-degree relatives of cancer cases, for each cancer site individually, and between cancer sites. We estimated the sex- and birth-year-specific rates for cancer using 1 million individuals in the resource. We applied these rates to groups of cases or relatives and compared the observed and expected numbers of cancers to estimate relative risks. RESULTS Many cancer sites show significantly elevated relative risks among distant relatives for cancer of the same site, strongly supporting a heritable contribution. Multiple combinations of cancer sites were observed among first-, second-, and third-degree relatives, suggesting the existence of heritable syndromes involving more than one cancer site. CONCLUSION This complete description of coaggregation of cancer by site in a well-defined population provides a set of observations supporting heritable cancer predispositions and may support the existence of genetic factors for many different cancers.
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Affiliation(s)
- Craig C Teerlink
- Division of Genetic Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
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Brandt A, Sundquist J, Hemminki K. Risk for incident and fatal prostate cancer in men with a family history of any incident and fatal cancer. Ann Oncol 2012; 23:251-256. [PMID: 21467126 DOI: 10.1093/annonc/mdr056] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Familial clustering of incident prostate cancer and some cancers at other discordant sites has been reported. Less is known about familial clustering of fatal prostate cancer with any fatal discordant cancers. Estimates on familial aggregation based on mortality are free from bias of overdiagnosis. PATIENTS AND METHODS We used the nationwide Swedish Family-Cancer Database to calculate standardized incidence ratios (SIRs) for incident prostate cancer for relatives of patients with any common cancer and standardized mortality ratios (SMRs) for death in prostate cancer for relatives of individuals who died from cancer. Similar risks were determined for any common cancer when relatives were affected by prostate cancer. RESULTS We observed familial aggregation of incident and fatal prostate cancers. Familial clustering (SIRs increased) of prostate cancer and of cancers at discordant sites was found for breast, ovarian, and kidney cancers and melanoma. Also, fatal prostate cancer clustered with these and cervical cancers (SMRs increased). CONCLUSIONS Our findings demonstrate that familial aggregation of prostate and breast cancers are not due to shared screening habits. The data on the association of cancers at discordant sites might be useful for clinical counseling and for mechanistic studies searching explanations to the familial clustering between discordant cancers.
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Affiliation(s)
- A Brandt
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - J Sundquist
- Center for Primary Care Research, Lund University, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, USA
| | - K Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany; Center for Primary Care Research, Lund University, Malmö, Sweden.
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De Ceglie A, Filiberti R, Blanchi S, Fontana V, Fisher DA, Grossi E, Lacchin T, De Matthaeis M, Ignomirelli O, Cappiello R, Casa DD, Foti M, Laterza F, Rosati R, Annese V, Iaquinto G, Conio M. History of cancer in first degree relatives of Barrett's esophagus patients: a case-control study. Clin Res Hepatol Gastroenterol 2011; 35:831-8. [PMID: 21924696 DOI: 10.1016/j.clinre.2011.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 07/26/2011] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Familial clusters of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) have been reported. This study evaluates the history of cancer in BE patients families. METHODS In two years, patients with BE (272), esophagitis (456) and controls (517) were recruited in 12 Italian Endoscopy Units. Cancer family history in first-degree (FD) relatives was determined by a questionnaire. RESULTS Approximately 53% of BE, 51% of esophagitis, and 48% of controls had at least one relative affected by any type of malignancy. Probands with at least one esophageal or gastric (E/G) cancer-affected relative showed a BE risk which was at least eighty-five percent higher than that of probands without affected relatives. The relative risk of BE was 4.18, 95% CL=0.76-23.04 if a FD relative had early (mean age ≤ 50 years) onset E/G cancer compared to late onset E/G cancer. CONCLUSION In this sample there was no evidence that a family history of cancer was associated with the diagnosis of BE. An intriguing result was the association between the occurrence of E/G cancers at earlier ages (< 50 years) among BE relatives with respect the control group. This could suggest a genetic contribution in onset of these tumors, but the sample was too small to demonstrate a significant association. Further exploration of family history of E/G cancer and a diagnosis of BE in larger samples is warranted.
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Affiliation(s)
- Antonella De Ceglie
- Unit of Digestive Endoscopy, Cancer Institute Giovanni Paolo II, Bari, Italy
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Hemminki K, Ji J, Sundquist J, Shu X. Familial risks in cancer of unknown primary: tracking the primary sites. J Clin Oncol 2010; 29:435-40. [PMID: 21189391 DOI: 10.1200/jco.2010.31.5614] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Cancer of unknown primary (CUP) is diagnosed at the metastatic stage, and despite extensive diagnostic work-up, the primary tumor often remains unidentified. No data are available on familial clustering of CUP. We hypothesize that familial clustering of CUP with other cancers may be informative of the primary sites. PATIENTS AND METHODS A total of 35,168 patients with CUP were identified in the Swedish Family-Cancer Database, and risks between family members were calculated for concordant (CUP-CUP) and discordant (CUP-any other cancer) cancers using standardized incidence ratio (SIR). RESULTS Familial cases of CUP accounted for 2.8% of all CUP cases in the offspring generation. Familial SIR for CUP was 1.69 when a sibling was diagnosed with CUP. As to discordant associations between siblings, CUP was associated with lung (SIR, 1.87), kidney (SIR, 1.82), liver (SIR, 1.67), ovarian (SIR, 1.45), colorectal (SIR, 1.26), and breast (SIR, 1.15) cancers and melanoma (SIR, 1.26). Upper aerodigestive tract, bladder, pancreatic, and prostate cancers were additionally associated with CUP. Notably, CUP was associated with families of kidney, lung, and colorectal cancers. CONCLUSION The present data show that CUP is not a disease of random metastatic cancers but, instead, a disease of a defined set of cancers. The association of CUP with families of kidney, lung, and colorectal cancers suggests a marked genetic basis and shared metastatic mechanisms by many cancer types. Familial sites shared by CUP generally match those arising in tissue-of-origin determinations and, hence, suggest sites of origin for CUP. Mechanistic exploration of CUP may provide insight into defense against primary tumors and the metastatic process.
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Jang JH, Cotterchio M, Gallinger S, Knight JA, Daftary D. Family history of hormonal cancers and colorectal cancer risk: a case-control study conducted in Ontario. Int J Cancer 2009; 125:918-25. [PMID: 19437533 DOI: 10.1002/ijc.24385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Aggregation of cancers among families with highly penetrant genetic mutations such as hereditary nonpolyposis colorectal cancer is well-described. However, there is a paucity of data regarding familial aggregation of hormonal cancers (cancers of the breast, endometrial, ovarian and prostate) and colorectal cancer (CRC) in the general population. We investigated the association between having a first-degree family history of breast, endometrial, ovarian, or prostate cancer and CRC risk. Population-based CRC cases and controls were recruited by the Ontario Familial Colorectal Cancer Registry (OFCCR). Logistic regression was conducted to obtain odds ratio (OR) estimates and 95% confidence intervals (95% CIs). First-degree family history of breast cancer was associated with a modest, borderline statistically significant increased CRC risk (age-, sex-adjusted OR = 1.2, 95% CI = 1.0, 1.5). The magnitude of CRC risk was greatest if more than one first-degree kin had breast cancer (age-, sex-adjusted OR = 1.7, 95% CI = 1.0, 2.0), as well as if the kin was diagnosed at >50 years of age (age-, sex-adjusted OR = 1.4, 95% CI = 1.1, 1.8). Family history of ovarian cancer was associated with reduced CRC risk (multivariate-adjusted OR = 0.6, 95% CI = 0.3, 1.0). Although statistically significant increases in CRC risk were observed in the age-, sex-adjusted OR estimates for family history of endometrial and prostate cancers, the associations were no longer significant after multivariate-adjustment. In conclusion, individuals with a first-degree kin with breast cancer may have a modest increased risk for CRC compared to individuals without.
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Affiliation(s)
- Ji-Hyun Jang
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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A compendium of familial relative risks of cancer among first degree relatives: a population-based study. Int J Cancer 2008; 123:1664-73. [PMID: 18623131 DOI: 10.1002/ijc.23615] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Familial clustering of cancer is expected to occur at practically all anatomical sites. However, few studies have had sufficient size to investigate different sites simultaneously and with adjustment for confounders. We evaluated familial clustering in the Netherlands Cohort Study in which 120,852 men and women, aged 55-69 years in 1986 were followed up for 13.3 years. 14,025 Probands, 6,629 parents and 4,271 siblings were diagnosed with cancer. Relative Risks (RR) of cancer in first degree family members were calculated by using multivariable Cox regression analyses. We also calculated false-positive reporting probabilities. Significant concordant familial clustering was observed for stomach (RR(father) = 1.89, RR(parent) = 1.66, RR(sister) = 3.33, RR(sibling) = 2.38, RR(1st degree) = 1.69), colon/rectum (RR(father) = 1.82, RR(mother) = 1.83, RR(parent) = 1.88, RR(1st degree) = 1.56), lung (RR(brother) = 1.50) and breast cancer (RR(mother) = 1.65, RR(sister) = 1.72, RR(1st degree) = 1.72) with low false-positive reporting probabilities. Significant discordant familial clustering has been observed for combinations of pancreas-colon/rectum (RR(mother) = 2.42, RR(parent) = 1.89, RR(1st degree) = 1.73), larynx-lung (RR(father) = 3.35, RR(parent) = 2.84, RR(1st degree) = 2.30), lung-oesophagus (RR(sibling) = 3.49), breast-bladder (RR(father) = 2.79, RR(parent) = 2.61), endometrium-stomach (RR(mother) = 2.32), ovarium-oesophagus (RR(1stdegree) = 4.19), prostate-colon/rectum (RR(parent) = 1.46) and bladder-larynx/pharynx (RR(father) = 2.49) cancer, although false-positive reporting probabilities were higher for these associations. Familial clustering of cancer occurs at most sites but is generally modest. Some observed discordant familial clustering is surprising but should be interpreted with caution as their prior probability is low.
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Ostrander EA, Johannesson B. Prostate cancer susceptibility loci: finding the genes. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2008; 617:179-90. [PMID: 18497042 DOI: 10.1007/978-0-387-69080-3_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
Abstract
Studies to date suggest that PC is a genetically very heterogeneous disease. High-risk families, in which multiple men are affected likely, reflect the contributions of a number of genes, some that are rare and highly penetrant, while others are more common and weakly penetrant. In this review, we have discussed only the first type of loci, and found that the identification of such genomic regions is a formidable problem. Replication between seemingly similar data sets is weak, likely reflecting the older age of onset associated with the disease, the inability to collect affected individuals from more than two generations in a family, and the variation seen in disease presentation, in addition to the underlying locus heterogeneity. Indeed, the definition of PC is ever changing, as diagnostic criteria and tools for pinpointing early lesions improve. Are we making progress? Clearly the answer is yes. The ability to divide large data sets into homogenous subset of families likely to share common genetic under-pinnings has improved power to identify loci and reproducibility between loci is now more common. Indeed, several groups report linkage to loci on chromosomes 1, 17, 19, and 22. Key to our continued success is our ever increasing ability to understand the disease. Identifying the subset of men who are likely to get clinically significant disease is the goal of genetic studies like these, and identifying the underlying loci is the key for developing diagnostics. The willingness of the community to work together has been an important factor in the successes the community has enjoyed to date, and will likely be as important as we move forward to untangle the genetics of this complex and common disorder.
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Affiliation(s)
- Elanie A Ostrander
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
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Johanneson B, Deutsch K, McIntosh L, Friedrichsen-Karyadi DM, Janer M, Kwon EM, Iwasaki L, Hood L, Ostrander EA, Stanford JL. Suggestive genetic linkage to chromosome 11p11.2-q12.2 in hereditary prostate cancer families with primary kidney cancer. Prostate 2007; 67:732-42. [PMID: 17372923 DOI: 10.1002/pros.20528] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The Seattle-based PROGRESS study was started in 1995 to ascertain hereditary prostate cancer (HPC) families for studies of genetic susceptibility. Subsequent studies by several research groups, including our own, suggest that HPC is a genetically heterogeneous disease. To be successful in mapping loci for such a complex disease, one must consider ways of grouping families into subsets that likely share the same genetic origin. Towards that end, we analyzed a genome-wide scan of HPC families with primary kidney cancer. METHODS An 8.1 cM genome-wide scan including 441 microsatellite markers was analyzed by both parametric and non-parametric linkage approaches in fifteen HPC families with the co-occurrence of kidney cancer. RESULTS There was no evidence for significant linkage in the initial findings. However, two regions of suggestive linkage were observed at 11q12 and 4q21, with HLOD scores of 2.59 and 2.10, respectively. The primary result on chromosome 11 was strengthened after excluding two families with members who had rare transitional cell carcinoma (TCC). Specifically, we observed a non-parametric Kong and Cox P-value of 0.004 for marker D11S1290 at 11p11.2. The 8 cM region between 11p11.2 and 11q12.2 was refined by the addition of 16 new markers. The subset of HPC families with a median age of diagnosis >65 years demonstrated the strongest evidence for linkage, with an HLOD = 2.50. The P-values associated with non-parametric analysis ranged from 0.004 to 0.05 across five contiguous markers. CONCLUSIONS Analysis of HPC families with members diagnosed with primary renal cell carcinoma demonstrates suggestive linkage to chromosome 11p11.2-q12.2.
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Affiliation(s)
- Bo Johanneson
- Cancer Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, Maryland, USA
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Suzuki T, Matsuo K, Wakai K, Hiraki A, Hirose K, Sato S, Ueda R, Tajima K. Effect of familial history and smoking on common cancer risks in Japan. Cancer 2007; 109:2116-23. [PMID: 17410537 DOI: 10.1002/cncr.22685] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Inherited genetic predispositions are important risk factors for the development of cancer in general. To determine genetic susceptibility for 14 common cancers, a case-control study of the impact of a family history of cancer in first-degree relatives was conducted. The authors further evaluated the effect modification by habitual smoking with adjustment for other confounding environmental factors. METHODS In total, 18,836 cancer cases and 28,125 age-matched and sex-matched controls, confirmed as being free of cancer, were recruited. Odds ratios (ORs) and 95% confidence intervals were determined by multiple logistic regression analysis, including stratification by family history for 14 cancer sites and interactions with a smoking history. RESULTS The associations between family history and risk of cancer were generally stronger at the same sites than across cancer sites. Risks to first-degree relatives at the same sites were found to be significantly elevated with 8 of 14 cancer sites; especially high ORs were found for prostate and thyroid cancers. Some across-site associations were observed; in particular, a reciprocal association between breast and prostate cancer was found. The interaction between family history and smoking history for breast cancer was found to be statistically significant. There was no statistical evidence for the interactions in other sites, but among subjects with a family history, the ORs were found to be higher in smokers compared with nonsmokers. CONCLUSIONS The results of the current study support the hypothesis of a genetic susceptibility to cancers in family members. For breast cancer, the interaction between family history and smoking history was observed to be significant.
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Affiliation(s)
- Takeshi Suzuki
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
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10
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Eldon BJ, Thorlacius S, Jonsson T, Jonasson JG, Kjartansson J, Bodvarsson S, Steingrimsson E, Rafnar T. A population-based study on the familial aggregation of cutaneous malignant melanoma in Iceland. Eur J Cancer 2006; 42:922-6. [PMID: 16530404 DOI: 10.1016/j.ejca.2005.11.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2005] [Revised: 11/16/2005] [Accepted: 11/21/2005] [Indexed: 01/19/2023]
Abstract
The aim of this study was to characterize the familial nature of cutaneous malignant melanoma (CMM) in Iceland. Risk ratio was used to estimate the risk among relatives of all CMM index cases diagnosed in Iceland over a 45-year period (1955-1999), using data from the National Cancer Registry and a genealogy database that covers the whole of Iceland's population. First-, second-, and third-degree relatives of CMM patients did not have an increased risk of the disease, and no added risk of other types of cancer among relatives was observed, except for thyroid cancer in first-degree male relatives. Seven individuals were diagnosed with two or more primary CMM in this period; none of these individuals had a first or second-degree relative with CMM. Altogether, 2.4% of cases were familial, as defined by commonly used criteria. In conclusion, high-penetrance susceptibility genes do not contribute much to CMM in the Icelandic population. The great majority of CMM cases in Iceland are most likely caused by the interplay between environmental causes and low-risk genes.
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Amundadottir LT, Thorvaldsson S, Gudbjartsson DF, Sulem P, Kristjansson K, Arnason S, Gulcher JR, Bjornsson J, Kong A, Thorsteinsdottir U, Stefansson K. Cancer as a complex phenotype: pattern of cancer distribution within and beyond the nuclear family. PLoS Med 2004; 1:e65. [PMID: 15630470 PMCID: PMC539051 DOI: 10.1371/journal.pmed.0010065] [Citation(s) in RCA: 217] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2004] [Accepted: 10/27/2004] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The contribution of low-penetrant susceptibility variants to cancer is not clear. With the aim of searching for genetic factors that contribute to cancer at one or more sites in the body, we have analyzed familial aggregation of cancer in extended families based on all cancer cases diagnosed in Iceland over almost half a century. METHODS AND FINDINGS We have estimated risk ratios (RRs) of cancer for first- and up to fifth-degree relatives both within and between all types of cancers diagnosed in Iceland from 1955 to 2002 by linking patient information from the Icelandic Cancer Registry to an extensive genealogical database, containing all living Icelanders and most of their ancestors since the settlement of Iceland. We evaluated the significance of the familial clustering for each relationship separately, all relationships combined (first- to fifth-degree relatives) and for close (first- and second-degree) and distant (third- to fifth-degree) relatives. Most cancer sites demonstrate a significantly increased RR for the same cancer, beyond the nuclear family. Significantly increased familial clustering between different cancer sites is also documented in both close and distant relatives. Some of these associations have been suggested previously but others not. CONCLUSION We conclude that genetic factors are involved in the etiology of many cancers and that these factors are in some cases shared by different cancer sites. However, a significantly increased RR conferred upon mates of patients with cancer at some sites indicates that shared environment or nonrandom mating for certain risk factors also play a role in the familial clustering of cancer. Our results indicate that cancer is a complex, often non-site-specific disease for which increased risk extends beyond the nuclear family.
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Affiliation(s)
- Laufey T Amundadottir
- 1deCODE GeneticsReykjavikIceland
- *To whom correspondence should be addressed. E-mail: (LTA), E-mail: (KS)
| | | | | | | | | | | | | | | | | | | | - Kari Stefansson
- 1deCODE GeneticsReykjavikIceland
- *To whom correspondence should be addressed. E-mail: (LTA), E-mail: (KS)
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Brunetti D, Tamaro P, Cavallieri F, Stanta G. Malignant tumors in first-degree relatives of cancer patients aged 0-25 years (province of Trieste, Italy). Int J Cancer 2003; 106:252-9. [PMID: 12800202 DOI: 10.1002/ijc.11198] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
To determine whether the occurrence of first and second primary malignancies in first-degree relatives of cancer patients aged 0-25 years (probands) differed from that in the general population, a cohort study was carried out on 860 relatives of 265 probands living in the province of Trieste, Italy. During the follow-up period (median duration = 28 years, 25th-75th percentile = 20-34), the relatives developed 103 first primary cancers vs. 88.9 expected for a standardized incidence ratio (SIR) of 1.2 (p = 0.2). Significantly elevated risks were found for melanoma in the parents of probands aged 15-25 years with melanoma (SIR = 15.0, p = 0.002), for hemolymphatic malignancies in the fathers of probands aged 0-14 years with brain tumors (SIR = 13.3, p = 0.0005) and for hemolymphatic cancers in relatives as a whole of probands aged 15-25 years with lymphomas (SIR = 4.5, p = 0.01). During the follow-up period, 7 relatives with a first primary cancer had a subsequent malignancy vs. 4.2 expected for an SIR of 1.7 (p = 0.3). Our results indicate that young cancer patients per se should not to be considered as a factor that usually increases the risk of developing malignant tumors among their first-degree relatives, except when a known cancer family syndrome or predisposition is recognized.
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Affiliation(s)
- Davide Brunetti
- Cancer Registry of the Province of Trieste, "S. Santorio" Hospital, Trieste, Italy
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Abstract
Major risk factors for developing prostate cancer, including positive family history and African-American ethnicity, can be quantified for genetic counseling. Factors increasing familial risk for prostate cancer are closer degree of kinship, number of affected relatives, and early age of onset (< 50 years) among the affected relatives. Genetic testing may be useful for modification of risk, but currently should be performed only within the context of a well-designed research study that will determine penetrance and genotype-phenotype correlation of specific mutations. Even in the absence of genetic testing, African-American men and men with a strong family history of prostate cancer may opt to initiate screening by prostate specific antigen (PSA) and digital rectal exam (DRE) screening at age 40.
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Affiliation(s)
- A M Nieder
- Department of Urology and NYU Cancer Institute, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA
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14
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Chappuis PO, Foulkes WD. Risk assessment & genetic testing. Cancer Treat Res 2002; 107:29-59. [PMID: 11775456 DOI: 10.1007/978-1-4757-3587-1_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Ovarian cancer is the fifth most common cause of cancer death in women in Western countries and family history is one of the strongest known risk factors. Approximately 5 to 13% of all ovarian cancer cases are caused by the inheritance of cancer predisposing genes with an autosomal pattern of transmission. The inherited fraction of ovarian cancer may differ between populations. Based on analysis of familial ovarian cancer pedigrees and other epidemiological studies, three hereditary ovarian cancer syndromes have been defined. The identification of the genes responsible for most hereditary ovarian cancers has open a new area of early detection methods and preventive procedures specifically dedicated to women identified as carrying ovarian cancer predisposing genes. Predictive oncology is best performed by a dedicated unit with professionals aware of all the issues surrounding genetic testing.
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Affiliation(s)
- Pierre O Chappuis
- Division of Medical Genetics, Department of Medicine, McGill University Health Center, Montreal, QC, Canada
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15
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FAMILIAL BLADDER CANCER IN THE NATIONAL SWEDISH FAMILY CANCER DATABASE. J Urol 2001. [DOI: 10.1097/00005392-200112000-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Llewellyn CD, Johnson NW, Warnakulasuriya KA. Risk factors for squamous cell carcinoma of the oral cavity in young people--a comprehensive literature review. Oral Oncol 2001; 37:401-18. [PMID: 11377229 DOI: 10.1016/s1368-8375(00)00135-4] [Citation(s) in RCA: 314] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There have been several reports of a rising incidence of oral cancer from many parts of the world. Although it is well known that oral cancer increases with age, recent trends for a rising incidence particularly relates to cancer of the tongue and mouth in young males. This review critically examines 46 publications devoted to oral cancer in the young adult. Most studies suggest that 4-6% of oral cancers now occur at ages younger than 40 years. Several studies examining risk factors for oral cancer in the young provide evidence that many younger patients have never smoked or consumed alcohol, which are recognised risk factors in older groups, or that duration of exposure may be too short for malignant transformation to occur. Information on many aspects of aetiology for this disease in the young implicating occupational, familial risk, immune deficits and virus infection are meagre. The spectrum of genetic abnormality disclosed is similar to older patients, there is paucity of specific studies involving younger cohorts, but predisposition to genetic instability has been hypothesised as a likely cause. Conflicting evidence is also reported on the sex distribution and outcome compared with older patients. Much work is required to understand the caveats related to global demography, risk factors and their diagnostic and prognostic markers for this disease which might be considered a disease distinct from that occurring in older patients.
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Affiliation(s)
- C D Llewellyn
- Department of Oral Medicine and Pathology, Guy's, King's and St Thomas' Schools of Medicine and Dentistry, WHO Collaborating Centre for Oral Cancer and Precancer, King's College Dental Institute, Caldecot Road, SE5 9RW, London, UK
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Dhillon PK, Farrow DC, Vaughan TL, Chow WH, Risch HA, Gammon MD, Mayne ST, Stanford JL, Schoenberg JB, Ahsan H, Dubrow R, West AB, Rotterdam H, Blot WJ, Fraumeni JF. Family history of cancer and risk of esophageal and gastric cancers in the United States. Int J Cancer 2001; 93:148-52. [PMID: 11391635 DOI: 10.1002/ijc.1294] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The worldwide rates for histology- and subsite-specific types of esophageal and gastric cancer reveal strikingly divergent patterns. The contribution of environmental and genetic factors has been explored in several high-incidence areas, but data on genetic influences are scarce for Western countries. Using data from a multicenter, population-based, case-control study on 1,143 cases and 695 controls in the United States, we evaluated whether a family history of digestive or other cancers was associated with an increased risk of esophageal adenocarcinoma (n = 293), esophageal squamous cell carcinoma (n = 221), gastric cardia adenocarcinoma (n = 261) or non-cardia gastric adenocarcinoma (n = 368). After adjusting for other risk factors, individuals reporting a family history of digestive cancers experienced no increased risk of either type of esophageal cancer but they were prone to adenocarcinomas of the gastric cardia [odds ratio (OR) = 1.34, 95% confidence interval (CI) 0.91-1.97] and non-cardia segments (OR =1.46, 95% CI 1.03-2.08). This familial tendency, particularly for non-cardia gastric tumors, was largely explained by an association with family history of stomach cancer (OR = 2.52, 95% CI 1.50-4.23). In addition, family history of breast cancer was associated with increased risks of esophageal adenocarcinoma (OR = 1.74, 95% CI 1.07-2.83) and non-cardia gastric adenocarcinoma (OR = 1.76, 95% CI 1.09-2.82). Also seen were non-significant familial associations of esophageal squamous-cell cancer with prostate cancer as well as non-cardia gastric cancer with leukemia and brain tumors, though these relationships must be interpreted with caution. Our data point to the role of familial susceptibility to gastric cancer, but not to any form of esophageal cancer, in the United States.
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Affiliation(s)
- P K Dhillon
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Chappuis PO, Ghadirian P, Foulkes WD. The role of genetic factors in the etiology of pancreatic adenocarcinoma: an update. Cancer Invest 2001; 19:65-75. [PMID: 11291558 DOI: 10.1081/cnv-100000076] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Pancreatic cancer is a disease with a very poor prognosis and its etiology is still largely elusive. The only consistent environmental risk factor is cigarette smoking. A previous history of pancreatitis or diabetes mellitus is also considered to be a risk factor. Epidemiological studies have confirmed that relatives of those with pancreatic cancer have an increased risk of this malignancy, and it has been evaluated that 3-5% of all pancreatic cancer cases are caused by genetic predisposition to the disease. Usually this occurs in the setting of a known inherited cancer syndrome caused by mutations in genes such as BRCA1/2 and CDKN2A. Whether or not a true site-specific pancreatic adenocarcinoma syndrome exists is not known. The real challenge for the management of high risk patients is to develop new screening methods than can identify pre-neoplastic or early neoplastic lesions in a timely manner.
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Affiliation(s)
- P O Chappuis
- Division of Medical Genetics, Department of Medicine, McGill University, Montreal General Hospital, Montreal, QC, Canada.
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Abstract
We used the nationwide Swedish Family-Cancer Database to analyze the risk for soft tissue tumors in offspring by parental cancers and in siblings of soft tissue tumor probands. Additionally, risk for second cancer following soft tissue tumor was investigated. In offspring, 1488 soft tissue tumors were diagnosed between years 1958 and 1996. Groups of offspring were compared by calculating standardized incidence ratios (SIRs) for soft tissue tumors. Parental breast, prostate and connective tissue cancers were associated with offspring soft tissue tumors in sex- and age-specific groups. The SIRs were of borderline significance, suggesting a small etiological contribution by Li-Fraumeni syndrome. Soft tissue tumors conveyed a high risk of second soft tissue tumor, probably partially due to recurrences. However, the observed risk for second nervous system cancer was consistent with Li-Fraumeni syndrome. Other associations were unlikely to be due to Li-Fraumeni or other known syndromes, but they could be spurious findings arising from multiple comparisons. Among these, parental stomach cancer (SIR 3.19, 95% CI 1.69-5.17) and endocrine gland tumors (SIR 3.66, 95% CI 1.32-7.17), particularly parathyroid tumors (SIR 4.46, 95% CI 1.41-9.23), were associated with offspring fibrosarcoma, and parental breast cancers with offspring leiomyosarcoma (SIR 2.04, 95% CI 1.08-3.30).
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Affiliation(s)
- K Hemminki
- Department of Biosciences at Novum, Karolinska Institute, 141 57, Huddinge, Sweden.
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Plna K, Hemminki K. Re: High frequency of multiple melanomas and breast and pancreas carcinomas in CDKN2A mutation-positive melanoma families. J Natl Cancer Inst 2001; 93:323-5. [PMID: 11181786 DOI: 10.1093/jnci/93.4.323] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Abstract
It is generally accepted that cancer is caused by environmental and inherited factors but these are only partially identified. Family studies can be informative but they do not separate shared lifestyles and genes. We estimate familial risks for concordant cancers between spouses in common cancers of both sexes in order to quantify cancer risks from the shared environment. The risks are compared to those seen between parents and offspring in order to estimate the inherited component. The nation-wide Family-Cancer Database was used as the source of family and cancer data. Standardized incidence ratios (SIRs) were calculated for concordant cancer in offspring by parental cancer and in spouses. Among the 23 cancer sites considered, all but two showed an increased SIR for offspring by father or mother. Only two sites, stomach and lung, showed an increase in SIR of concordant cancer among spouses. Additionally, pancreatic cancer and melanoma were increased in couples where at least one spouse was diagnosed before age 50. If both spouses presented melanoma before age 40, SIR was 3.82 for husbands. SIRs of colon, renal, and skin (squamous cell) cancers were unchanged by spouses' concordant cancer. Shared lifestyle among spouses seems to explain only a small proportion of cancer susceptibility. Because lifestyles are likely to differ more between parents and offspring than between spouses, familial cancer risks between parents and offspring are likely to be more due to heritable rather than environmental effects.
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Affiliation(s)
- K Hemminki
- Department of Biosciences at Novum, Karolinska Institute, Huddinge, Sweden.
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23
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Abstract
It is commonly believed that cancer is a multistage, polygenic disease. Even though conceptually appealing, the evidence supporting the multistage theory remains limited. Most known tumor suppresser genes are associated with monogenic dominant cancers following a two-hit pathway. We review results from a recent twin study on 90000 individuals that give support to the multistage theory. Statistically significant heritability estimates were shown for cancers of the colorectum (35%), breast (27%), and prostate (42%). These estimates are much higher than those obtained from family studies in which parents and offspring, or sibs are compared. The difference can be accounted for by the involvement of many genes. A polygenic cancer would show small effects in family studies but large effects in twin studies. We present calculations on the decrease in familial risks when the number of genes involved increases or when the penetrance decreases. We test the apparent number of stages involved in the main cancers from the Swedish Family-Cancer Database. The logarithms of the slopes suggest large differences in the apparent numbers of mutations involved in different cancers. The number of mutations required appears to be less in familial breast cancer compared to sporadic breast cancer. Study designs for gene identification should be revised to accommodate polygenic cancers.
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Affiliation(s)
- K Hemminki
- Department of Biosciences at Novum, Karolinska Institute, 14157, Huddinge, Sweden.
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Hemminki K, Lönnstedt I, Vaittinen P, Lichtenstein P. Estimation of genetic and environmental components in colorectal and lung cancer and melanoma. Genet Epidemiol 2001; 20:107-116. [PMID: 11119300 DOI: 10.1002/1098-2272(200101)20:1<107::aid-gepi9>3.0.co;2-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cancer has predominant environmental and somatic causes but the assessment of hereditary (genetic) causes is difficult, except for highly penetrant single-gene causes. Family studies are only partially informative in this regard because family members share diet and life-styles. Twin studies have been classically used to disentangle the effects of heredity and environment on disease etiology. We estimate the genetic and environmental components in colorectal and lung cancer and melanoma by comparing cancer risks in family members. The Swedish Family-Cancer Database, comprising more than 6 million individuals, was used as the source of family and cancer data. Tetrachoric correlations were used to describe similarity in cancer liability among family members. Structural equation modelling was used to derive estimates of the importance of genetic and environmental effects. The estimated genetic component ranged from 10% in colon and colorectal cancer to 18% in melanoma. For lung cancer, the share was 14%. If assortative mating were important for liability to cancer, these heritability estimates may be an underestimation of the true genetic effects. Non-shared environmental effect was 67-68% in colorectal cancer and melanoma, and 71% in lung cancer. Shared and childhood environments were equally important in colorectal cancer and melanoma, whereas no childhood effect was observed for lung cancer.
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Affiliation(s)
- K Hemminki
- Department of Biosciences at Novum, Karolinska Institute, Huddinge, Sweden.
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Hemminki K, Vaittinen P, Easton D. Familial cancer risks to offspring from mothers with 2 primary breast cancers: leads to cancer syndromes. Int J Cancer 2000; 88:87-91. [PMID: 10962444 DOI: 10.1002/1097-0215(20001001)88:1<87::aid-ijc14>3.0.co;2-f] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The nationwide Swedish Family-Cancer Database was used to analyse the risk of cancer among the offspring of bilateral breast cancer patients. We studied 4,734 such mothers who had 9,391 offspring, of whom 328 presented with a primary cancer in the years 1958-1996. Standardised incidence ratios (SIRs) were increased for breast [SIR 3.05, 95% confidence interval (CI) 2.57-3.59], ovarian (SIR 1.84, 95% CI 1.03-3.05) and anogenital (SIR 1.75, 95% CI 1.11-2.63) cancers and childhood sarcomas (SIR 9.39, 95% CI 1.93-29.13). Additionally, squamous-cell skin cancer was increased among sons and all childhood cancers among daughters. When analysed by histological type, adenocarcinomas of the breast and ovary, all squamous-cell carcinomas and tumours at glandular epithelium (seminomas and intestinal carcinoids) were increased. Mothers with bilateral breast cancer had an excess of 2 or more children with cancer. The increased risk of ovarian cancer is consistent with germline mutations in the BRCA1 and BRCA2 genes, while the risk of soft tissue and bone sarcomas may reflect the association of these tumours with Li-Fraumeni syndrome. The increases in squamous-cell carcinomas at many sites may reflect a new susceptibility syndrome.
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Affiliation(s)
- K Hemminki
- Department of Biosciences, Karolinska Institute, Huddinge, Sweden.
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Abstract
We used the Swedish Family-Cancer Database to analyze the spectrum of cancers diagnosed in husbands of women with in situ or invasive cervical cancer, and we compared these to second carcinogenic events in women presenting with these cancers. Our hypothesis was increased cancer susceptibility from human papilloma virus (HPV). When the wives had in situ or invasive cervical cancer, the standard incidence ratios (SIRs) for anal cancer in husbands were 1.75 (95% CI = 1.05-2.62) and 1.92 (95% CI = 0.69-3.76). Anal cancer was also increased as a second primary cancer in women. Other common cancers were related to tobacco smoking. The results indicate that HPV infection is associated with anal cancer in both men and women.
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Affiliation(s)
- K Hemminki
- Department of Biosciences at Novum, Karolinska Institute, Huddinge, Sweden
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Abstract
The Swedish Family-Cancer Database, which was updated in 1999 to cover individuals born after 1934 with their biological parents, totals 9.6 million persons. We used this resource to study invasive and in situ skin cancers. We identified 198 families in which a parent and an offspring had skin cancer. The familial standardized incidence ratios (SIRs) were 2.4 for invasive and 2.8 for in situ skin cancers in offspring. The SIRs for offspring depended only weakly on the age at diagnosis, as evaluated in two age groups. Compared with offspring whose parents had a single skin cancer, offspring whose parents had multiple skin cancers had a 70% increase in SIR. The discordant parental cancer sites that showed associations with skin cancer in offspring were melanoma, ocular melanoma, and a group of cancers observed in immunosuppressed patients.
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Affiliation(s)
- K Hemminki
- Department of Biosciences at Novum, Karolinska Institute, Huddinge, Sweden
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29
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Abstract
The Swedish Family-Cancer Database was used to analyze familial relationships in mothers and daughters in invasive and in situ cervical cancers from years 1958-1994, including a total of 125,000 in situ and 14,000 invasive cancers. In situ cancers were diagnosed on average 10 years earlier than invasive cancers. Familial relative risks (FRRs) were calculated separately for mothers and daughters, and were between 1.8 and 2.3 for the 2 forms. The risks were only slightly modified by age of onset, except at higher ages where there was no familial risk; in mothers, the risks increased if more than one daughter was affected. Aggregation of in situ cases among sisters was observed in families. Heritability estimates were between 0.11 and 0.15 for in situ and 0.22 and 0.34 for invasive cervical cancer. A comparison of cancers in mothers and daughters showed an association between cervical cancer and many cancer types observed in immunosuppressed patients, suggesting a role for a mild form of immunosuppression, in addition to sexual behavior leading to human-papilloma-virus infections, in familial cervical cancer.
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Affiliation(s)
- K Hemminki
- Department of Biosciences, Novum, Karolinska Institute, Huddinge, Sweden.
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