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Barnett MI, Wassie MM, Cock C, Bampton PA, Symonds EL. Low Incidence of Colorectal Advanced Neoplasia During Surveillance in Individuals with a Family History of Colorectal Cancer. Dig Dis Sci 2023; 68:4243-4251. [PMID: 37682374 PMCID: PMC10570165 DOI: 10.1007/s10620-023-08053-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/21/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Family history of colorectal cancer (CRC) is used to stratify individuals into risk categories which determine timing of initial screening and ongoing CRC surveillance. Evidence for long-term CRC risk following a normal index colonoscopy in family history populations is limited. AIMS To assess the incidence of advanced neoplasia and associated risk factors in a population undergoing surveillance colonoscopies due to family history of CRC. METHODS Surveillance colonoscopy findings were examined in 425 individuals with a family history of CRC, a normal index colonoscopy and a minimum of 10 years of follow-up colonoscopies. Advanced neoplasia risk was determined for three CRC family history categories (near-average, medium and high-risk), accounting for demographics and time after the first colonoscopy. RESULTS The median follow-up was 13.5 years (IQR 11.5-16.0), with an incidence of advanced neoplasia of 14.35% (61/425). The number of affected relatives and age of CRC diagnosis in the youngest relative did not predict the risk of advanced neoplasia (p > 0.05), with no significant differences in advanced neoplasia incidence between the family history categories (p = 0.16). Patients ≥ 60 years showed a fourfold (HR 4.14, 95% CI 1.33-12.89) higher advanced neoplasia risk during surveillance than those < 40 years at index colonoscopy. With each subsequent negative colonoscopy, the risk of advanced neoplasia at ongoing surveillance was reduced. CONCLUSIONS The incidence of advanced neoplasia was low (14.35%), regardless of the family history risk category, with older age being the main risk for advanced neoplasia. Delaying onset of colonoscopy or lengthening surveillance intervals could be a more efficient use of resources in this population.
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Affiliation(s)
| | - Molla M Wassie
- Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| | - Charles Cock
- Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
- Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, SA, 5042, Australia
| | - Peter A Bampton
- Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| | - Erin L Symonds
- Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
- Bowel Health Service, Flinders Medical Centre, Bedford Park, SA, 5042, Australia
- Level 3, Flinders Centre for Innovation in Cancer, Bedford Park, SA, 5042, Australia
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Abhari RE, Thomson B, Yang L, Millwood I, Guo Y, Yang X, Lv J, Avery D, Pei P, Wen P, Yu C, Chen Y, Chen J, Li L, Chen Z, Kartsonaki C. External validation of models for predicting risk of colorectal cancer using the China Kadoorie Biobank. BMC Med 2022; 20:302. [PMID: 36071519 PMCID: PMC9454206 DOI: 10.1186/s12916-022-02488-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In China, colorectal cancer (CRC) incidence and mortality have been steadily increasing over the last decades. Risk models to predict incident CRC have been developed in various populations, but they have not been systematically externally validated in a Chinese population. This study aimed to assess the performance of risk scores in predicting CRC using the China Kadoorie Biobank (CKB), one of the largest and geographically diverse prospective cohort studies in China. METHODS Nine models were externally validated in 512,415 participants in CKB and included 2976 cases of CRC. Model discrimination was assessed, overall and by sex, age, site, and geographic location, using the area under the receiver operating characteristic curve (AUC). Model discrimination of these nine models was compared to a model using age alone. Calibration was assessed for five models, and they were re-calibrated in CKB. RESULTS The three models with the highest discrimination (Ma (Cox model) AUC 0.70 [95% CI 0.69-0.71]; Aleksandrova 0.70 [0.69-0.71]; Hong 0.69 [0.67-0.71]) included the variables age, smoking, and alcohol. These models performed significantly better than using a model based on age alone (AUC of 0.65 [95% CI 0.64-0.66]). Model discrimination was generally higher in younger participants, males, urban environments, and for colon cancer. The two models (Guo and Chen) developed in Chinese populations did not perform better than the others. Among the 10% of participants with the highest risk, the three best performing models identified 24-26% of participants that went on to develop CRC. CONCLUSIONS Several risk models based on easily obtainable demographic and modifiable lifestyle factor have good discrimination in a Chinese population. The three best performing models have a higher discrimination than using a model based on age alone.
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Affiliation(s)
- Roxanna E Abhari
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
| | - Blake Thomson
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, Big Data Institute Building, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Iona Millwood
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, Big Data Institute Building, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Yu Guo
- Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Xiaoming Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, China
| | - Daniel Avery
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
| | - Pei Pei
- Chinese Academy of Medical Sciences, Building C, NCCD, Shilongxi Rd., Mentougou District, Beijing, 102308, China
| | - Peng Wen
- Maiji CDC, No. 29 Shangbu Road, Maiji, Tianshui, 741020, Gansu, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, China
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, Big Data Institute Building, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Junshi Chen
- National Center for Food Safety Risk Assessment, 37 Guangqu Road, Beijing, 100021, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, Big Data Institute Building, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Christiana Kartsonaki
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK.
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, Big Data Institute Building, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK.
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Roos VH, Mangas-Sanjuan C, Rodriguez-Girondo M, Medina-Prado L, Steyerberg EW, Bossuyt PMM, Dekker E, Jover R, van Leerdam ME. Effects of Family History on Relative and Absolute Risks for Colorectal Cancer: A Systematic Review and Meta-Analysis. Clin Gastroenterol Hepatol 2019; 17:2657-2667.e9. [PMID: 31525516 DOI: 10.1016/j.cgh.2019.09.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/27/2019] [Accepted: 09/08/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Guidelines recommend that individuals with familial colorectal cancer undergo colonoscopy surveillance instead of average-risk screening. However, these recommendations vary widely. To substantiate appropriate surveillance strategies, precise and valid evidence-based risk estimates are needed for individuals with a family history of colorectal cancer (CRC). METHODS We systematically searched MEDLINE, EMBASE, and Cochrane from inception to July 2018 for case-control and cohort studies investigating the effect of family history on CRC risk. We calculated summary estimates of pooled relative risks (RRs) using a random-effects model. Life tables were created to convert RR estimates into absolute risk estimates. RESULTS We screened 4417 articles and identified 42 eligible case-control and 20 cohort studies. In case-control studies, the RR for CRC in patients with 1 first-degree relative (FDR with CRC) was 1.92 (95% CI, 1.53-2.41) and 1.37 (95% CI, 0.76-2.46) for cohort studies. For individuals with 2 or more FDRs with CRC, the RR was 2.81 in case-control studies (95% CI, 1.73-4.55) and 2.40 in cohort studies (95% CI, 1.76-3.28). For individuals having a FDR diagnosed with CRC at an age younger than 50 years, the RR for CRC in their FDRs was 3.57 in case-control studies (95% CI, 1.07-11.85) and 3.26 in cohort studies (95% CI, 2.82-3.77). The cumulative absolute risks for CRC at 85 years in Western Europe were 4.8% for persons with 1 FDR with CRC (95% CI, 2.7%-8.3%), 8.2% for individuals with 2 or more FDRs (95% CI, 6.1%-10.9%), and 11% for persons with a FDR diagnosed with CRC at an age younger than 50 years (95% CI, 9.5%-12.4%). CONCLUSIONS In this systematic review and meta-analysis, we found that the RR of CRC among FDRs is lower than previously expected, especially based on cohort studies. Risk estimates are affected by the number of relatives with CRC and their age at diagnosis. Intensified colonoscopy surveillance strategies could be considered for high-risk groups. PROSPERO trial identification no: CRD42018103058.
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Affiliation(s)
- Victorine H Roos
- Department of Gastroenterology and Hepatology, University of Amsterdam, Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Carolina Mangas-Sanjuan
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Spain
| | - Mar Rodriguez-Girondo
- Department of Biomedical Data Sciences, Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Lucia Medina-Prado
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Spain
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Patrick M M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Evelien Dekker
- Department of Gastroenterology and Hepatology, University of Amsterdam, Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Rodrigo Jover
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Spain
| | - Monique E van Leerdam
- Department of Gastroenterology and Hepatology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands.
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Abstract
BACKGROUND Many studies have indicated that colon and rectal cancers differ in etiology and histology. OBJECTIVE The aim of this study was to investigate whether the associations of colon and rectal cancers with any other (discordant) cancer were site specific. DESIGN A novel approach was implemented in which cancer risks were analyzed in families with increasing numbers of family members diagnosed with defined cancers. The novel assumption was that, for a true familial association, the risk should increase by the number of affected family members. In separate analyses, familial risks were calculated after the exclusion of putative families with hereditary nonpolyposis colorectal cancer. SETTINGS The study was conducted using the Swedish Family-Cancer Database. MAIN OUTCOME MEASURES The outcome measure was relative risk. RESULTS Relative risks of colorectal cancer and colon cancer were higher when family members were diagnosed with colon cancer than when family members were diagnosed with rectal cancer (incidence rate ratio for colorectal: 1.82 (95% CI, 1.74-1.90) vs 1.61 (95% CI, 1.51-1.71); incidence rate ratio for colon: 1.92 (95% CI, 1.83-2.02) vs 1.56 (95% CI, 1.45-1.69)). Relative risks for 10 discordant cancers were increased in colon or rectal cancer families, whereas none of the relative risks differed significantly between colon and rectal cancers. After deleting hereditary nonpolyposis colorectal cancer families, the relative risks of endometrial and ovarian cancers were no longer significant. LIMITATIONS Genetic data are unavailable in the database. CONCLUSIONS Our results suggested that familial risks for colon cancer were higher than risks for rectal cancer in families of patients with colorectal cancer and colon cancer. The relationships of lung cancer and nervous system cancer with colorectal cancer were site specific. The associations of colon and rectal cancers with lung cancer, myeloma, and cancer of unknown primary appeared not to point out known syndromes and may suggest involvement of a novel predisposition. See Video Abstract at http://links.lww.com/DCR/A791.
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Jenkins MA, Ait Ouakrim D, Boussioutas A, Hopper JL, Ee HC, Emery JD, Macrae FA, Chetcuti A, Wuellner L, St John DJB. Revised Australian national guidelines for colorectal cancer screening: family history. Med J Aust 2018; 209:455-460. [DOI: 10.5694/mja18.00142] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/06/2018] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | - Hooi C Ee
- Sir Charles Gardiner Hospital, Perth, WA
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Norton PA, Allen-Brady K, Cannon-Albright LA. The familiality of pelvic organ prolapse in the Utah Population Database. Int Urogynecol J 2012; 24:413-8. [DOI: 10.1007/s00192-012-1866-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Accepted: 06/16/2012] [Indexed: 12/17/2022]
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Abstract
The first part of the chapter describes the Icelandic Genealogical Database, how it was created, what it contains, and how it operates. In the second part, an overview of research accomplished with material from the database is given.
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Affiliation(s)
- Hrafn Tulinius
- The Genetical Committee of the University of Iceland, Reykjavik, Iceland.
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Snaebjornsson P, Jonasson L, Jonsson T, Möller PH, Theodors A, Jonasson JG. Colon cancer in Iceland--a nationwide comparative study on various pathology parameters with respect to right and left tumor location and patients age. Int J Cancer 2010; 127:2645-53. [PMID: 20162576 DOI: 10.1002/ijc.25258] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Increasing evidence suggests genetic, biological and demographical difference between right and left colon cancer. Studies have also indicated age differences in the pathology of colon cancer. There is a scarcity of large-scale studies that closely examine the pathological differences regarding age and tumor location. The aim of our study was to do an extensive comparison of right- and left- sided colon cancers as well as comparing patients <50 years with older patients. A retrospective, population-based study was carried out on all patients with colon cancer in Iceland between 1955 and 2004. A total of 2293 cases were analyzed (1148 men, 1145 women). All histopathology material was re-evaluated. Differences in tumor characteristics between right and left location and younger (<50) and older (≥50) patients was evaluated in particular. Higher TNM-stage, larger tumors, vessel invasion, mucinous type, high grade and expanding tumor border occurred more frequently in right- versus left-sided lesions while annular and polypoid tumors were more common in left-sided tumors (p < 0.05). Young patients had more frequent lymph node metastases, vessel invasion, nonpolypoid lesions and infiltrating tumor border (p < 0.05). Right-sided lesions show more aggressive features, reflected in morphology and stage. Younger patients present more frequently with adverse features than do older patients. Frequency of right- and left-sided colon cancer differs by age with pronounced age-location differences in females. This supports the assumption of differences in etiology and carcinogenesis of right- and left-sided colon cancer, and between young and old patients.
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Neklason DW, Tuohy TM, Stevens J, Otterud B, Baird L, Kerber RA, Samowitz WS, Kuwada SK, Leppert MF, Burt RW. Colorectal adenomas and cancer link to chromosome 13q22.1-13q31.3 in a large family with excess colorectal cancer. J Med Genet 2010; 47:692-9. [PMID: 20522424 PMCID: PMC3050714 DOI: 10.1136/jmg.2009.076091] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Colorectal cancer is the fourth most common type of cancer and the second most common cause of cancer death. Fewer than 5% of colon cancers arise in the presence of a clear hereditary cancer condition; however, current estimates suggest that an additional 15-25% of colorectal cancers arise on the basis of unknown inherited factors. AIM To identify additional genetic factors responsible for colon cancer. METHODS A large kindred with excess colorectal cancer was identified through the Utah Population Database and evaluated clinically and genetically for inherited susceptibility. RESULTS A major genetic locus segregating with colonic polyps and cancer in this kindred was identified on chromosome 13q with a non-parametric linkage score of 24 (LOD score of 2.99 and p=0.001). The genetic region spans 21 Mbp and contains 27 RefSeq genes. Sequencing of all candidate genes in this region failed to identify a clearly deleterious mutation; however, polymorphisms segregating with the phenotype were identified. Chromosome 13q is commonly gained and overexpressed in colon cancers and correlates with metastasis, suggesting the presence of an important cancer progression gene. Evaluation of tumours from the kindred revealed a gain of 13q as well. CONCLUSIONS This identified region may contain a novel gene responsible for colon cancer progression in a significant proportion of sporadic cancers. Identification of the precise gene and causative genetic change in the kindred will be an important next step to understanding cancer progression and metastasis.
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Affiliation(s)
- Deborah W Neklason
- Department of Oncological Sciences, University of Utah, Salt Lake City, Utah, USA.
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Bapat B, Lindor NM, Baron J, Siegmund K, Li L, Zheng Y, Haile R, Gallinger S, Jass JR, Young JP, Cotterchio M, Jenkins M, Grove J, Casey G, Thibodeau SN, Bishop DT, Hopper JL, Ahnen D, Newcomb PA, Le Marchand L, Potter JD, Seminara D. The association of tumor microsatellite instability phenotype with family history of colorectal cancer. Cancer Epidemiol Biomarkers Prev 2009; 18:967-75. [PMID: 19258475 DOI: 10.1158/1055-9965.epi-08-0878] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Family history is a strong predictor of colorectal cancer risk; however, a diagnosis of colorectal cancer among first-degree relatives has not been systematically investigated as a function of the colorectal cancer molecular subtypes related to tumor microsatellite instability (MSI) status. We investigated whether the observable familial colorectal cancer risks differed according to tumor MSI subtypes, stratified as MSI-High (>30% instability), MSI-Low (<30% instability), and MSS (no instability). Data from 3,143 population-based colorectal cancer cases from five institutions were assessed for family history according to the Amsterdam criteria and the Bethesda guidelines, age at diagnosis, sex, tumor location, and MSI status. The distribution of patient characteristics by MSI status was compared using polytomous logistic regression. Overall, 2.8% colorectal cancer cases met the Amsterdam criteria and 37% met the Bethesda guidelines. There were 14% MSI-High, 13% MSI-Low, and 73% MSS colorectal cancers. MSI-High (P<0.0001) and MSI-Low tumors (P=0.01) were more proximally located than MSS tumors. MSI-High tumors were more common among females (P<0.001). The highest proportion of MSI-High tumors occurred in cases<40 years of age whereas the age-dependent distribution of MSI-Low tumors was unchanged. MSI-High tumors showed a statistically significant association with increasing numbers of first-degree relatives with colorectal cancer (P=0.002); this association disappeared, however, when MSI-High cases meeting Amsterdam criteria were removed from the analysis. MSI-Low tumors did not show a similar association with family history of colorectal cancer. Familial risk associated with MSI-High tumors is primarily driven by the Amsterdam-criteria patients. MSI-Low tumors may represent a distinct subtype of colorectal cancer with respect to certain epidemiologic variables studied here.
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Affiliation(s)
- Bharati Bapat
- Department of Pathology and Lab Medicine, Mount Sinai Hospital, and Samuel Lunenfeld Research Institute, University of Toronto, 60 Murray Street, Box 30, Toronto, M5T 3L9, Ontario, Canada.
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Leu M, Reilly M, Czene K. Evaluation of Bias in Familial Risk Estimates: A Study of Common Cancers Using Swedish Population-based Registers. J Natl Cancer Inst 2008; 100:1318-25. [DOI: 10.1093/jnci/djn290] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Hiripi E, Bermejo JL, Sundquist J, Hemminki K. Association of colorectal adenoma with other malignancies in Swedish families. Br J Cancer 2008; 98:997-1000. [PMID: 18283306 PMCID: PMC2266856 DOI: 10.1038/sj.bjc.6604276] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Using the Swedish Family-Cancer Database covering over 11.5 million individuals, estimated relative risks (RRs) for colorectal adenoma were using Poisson's regression. The RR of colorectal adenoma was found to be increased among first-degree relatives of patients with colorectal cancer (2.72; 95% confidence interval=2.46-3.00) and among the offspring and siblings of patients with endometrial and prostate cancers. We also found an increased risk of colorectal adenoma for the offspring of individuals with stomach cancer and leukaemia, and for siblings of those with pancreatic cancer and multiple myeloma. Our results suggest that colorectal adenoma may share a genetic aetiology with cancer even at extracolorectal sites. Increases of colorectal adenoma in families affected by prostate cancer and acute leukaemia cannot be attributed to known cancer syndromes, although the play of chance cannot be excluded.
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Affiliation(s)
- E Hiripi
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120, Germany.
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Noe M, Schroy P, Demierre MF, Babayan R, Geller AC. Increased cancer risk for individuals with a family history of prostate cancer, colorectal cancer, and melanoma and their associated screening recommendations and practices. Cancer Causes Control 2007; 19:1-12. [PMID: 17906935 DOI: 10.1007/s10552-007-9064-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2007] [Accepted: 08/29/2007] [Indexed: 02/08/2023]
Abstract
Prostate cancer, colorectal cancer, and melanoma are three malignancies that appear to have strong genetic components that can confer additional risk to family members. Screening tools, albeit controversial, are widely available to potentially aide in early diagnosis. Family members are now more attuned to the risks and benefits of cancer screening, thus, it is imperative that physicians understand the screening tools and how to interpret the information they provide. We reviewed the current literature regarding the cancer risks for individuals with a family history of prostate cancer, colon cancer, and melanoma, the current screening recommendations for family members, and actual screening practices of individuals with a family history of these malignancies. This review should serve as a guide for physicians and cancer control planners when advising their patients and the public regarding screening decisions.
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Affiliation(s)
- Megan Noe
- Tufts University School of Medicine, Boston, MA, USA
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Alexander CL, Urbanski SJ, Hilsden R, Rabin H, MacNaughton WK, Beck PL. The risk of gastrointestinal malignancies in cystic fibrosis: case report of a patient with a near obstructing villous adenoma found on colon cancer screening and Barrett's esophagus. J Cyst Fibros 2007; 7:1-6. [PMID: 17766191 DOI: 10.1016/j.jcf.2007.07.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Revised: 07/04/2007] [Accepted: 07/07/2007] [Indexed: 02/07/2023]
Abstract
The life expectancy for cystic fibrosis (CF) patients has increased dramatically over the last 30 years. Although the overall cancer risk for CF patients does not appear to be increased there is a marked increased risk of gastrointestinal malignancies especially in the post lung transplant population. CF patients that do develop gastrointestinal malignancies do so at an earlier age and there is often a lag in the diagnosis and management of these individuals. We present a 39 year old male CF patient that underwent a colonoscopy for colon cancer screening and a large, near obstructing, villous adenoma of his ileum was found. The polyp was removed successfully via endoscopy without incident and there was no evidence of malignancy. An upper endoscopy revealed a long segment of Barrett's esophagus with no evidence of dysplasia. We present this case as well as a detailed review of the literature on cancer risk in CF and a discussion of the mechanisms that may be involved. We also present the risk of GI malignancies in non-CF patients as a guide on how to assess and manage the risk of GI malignancies in this ever-changing patient population.
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Affiliation(s)
- C L Alexander
- Gastrointestinal Research Group and Inflammation Research Network, Institute of Infection, Immunity and Inflammation, University of Calgary, Calgary, Alberta, Canada
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Maul JS, Burt RW, Cannon-Albright LA. A familial component to human rectal cancer, independent of colon cancer risk. Clin Gastroenterol Hepatol 2007; 5:1080-4. [PMID: 17625976 PMCID: PMC2176153 DOI: 10.1016/j.cgh.2007.04.025] [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: 02/07/2023]
Abstract
BACKGROUND & AIMS The Utah Population Database (UPDB) is unique; it links genealogy for over 2 million Utah individuals to a statewide Cancer Registry. We have investigated the familial nature of rectal cancer, considered independently from colon cancer. METHODS We estimated relative risks in relatives, and average relatedness among rectal cancer patients using matched controls from the UPDB. RESULTS There is a significant increased risk for rectal cancer in first-degree relatives of rectal cancer patients (relative risk [RR], 1.97), equivalent to the risk for colon cancer (RR, 2.11). The significant increased risk for rectal cancer extends to second- and third-degree relatives. The RR for rectal cancer among first-degree relatives of young-onset rectal cancer patients (<55 y), is equivalent (RR, 3.34) to their risk of colon cancer (RR, 3.35). CONCLUSIONS The UPDB provides strong evidence for a familial component to rectal cancer that may include a genetic component in addition to shared environment. There is a significant increased risk of rectal cancer in the close and distant relatives of rectal cancer patients, which is even higher among relatives of young-onset patients. Although it has been reported that relatives of colon cancer probands are at increased risk for colorectal cancer, the risk of large-bowel cancer among relatives of rectal cancer patients has been less clear. Relatives of rectal cancer probands experience a risk of cancer of the large bowel that is at least as high as the risk previously reported for relatives of individuals with colon cancer.
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Affiliation(s)
- John Scott Maul
- Department of Medical Oncology, University of Utah School of Medicine, Salt Lake City, UT
| | - Randall W. Burt
- Department of Cancer Outreach and Prevention, Huntsman Cancer Institute, Salt Lake City, UT
| | - Lisa A. Cannon-Albright
- Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT
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