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Sipilä LJ, Seppä K, Aavikko M, Ravantti J, Heikkinen S, Aaltonen LA, Pitkäniemi J. Sex-specific familial aggregation of cancers in Finland. Sci Rep 2022; 12:15126. [PMID: 36068325 PMCID: PMC9448814 DOI: 10.1038/s41598-022-19039-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/23/2022] [Indexed: 12/24/2022] Open
Abstract
Despite the fact that the effect of sex on the occurrence of cancers has been studied extensively, it remains unclear whether sex modifies familial aggregation of cancers. We explored sex-specific familial aggregation of cancers in a large population-based historical cohort study. We combined cancer and population registry data, inferring familial relationships from birth municipality-surname-sex (MNS) combinations. Our data consisted of 391,529 incident primary cancers in 377,210 individuals with 319,872 different MNS combinations. Cumulative sex-specific numbers of cancers were compared to expected cumulative incidence. Familial cancer risks were similar between the sexes in our population-wide analysis. Families with concordant cancer in both sexes exhibited similar sex-specific cancer risks. However, some families had exceptionally high sex-specific cumulative cancer incidence. We identified six families with exceptionally strong aggregation in males: three families with thyroid cancer (ratio between observed and expected incidence 184.6; 95% credible interval (95% CI) 33.1–1012.7, 173.4 (95% CI 65.4–374.3), and 161.4 (95% CI 29.6–785.7), one with stomach (ratio 14.4 (95% CI 6.9–37.2)), colon (ratio 15.5 (95% CI 5.7–56.3)) cancers and one with chronic lymphocytic leukaemia (ratio 33.5 (95% CI 17.2–207.6)). Our results imply that familial aggregation of cancers shows no sex-specific preference. However, the atypical sex-specific aggregation of stomach cancer, colon cancer, thyroid cancer and chronic lymphocytic leukaemia in certain families is difficult to fully explain with present knowledge of possible causes, and could yield useful knowledge if explored further.
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Affiliation(s)
- Lauri J Sipilä
- Department of Medical and Clinical Genetics, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Applied Tumor Genomics Research Program, Research Programs Unit, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland
| | - Karri Seppä
- Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland
| | - Mervi Aavikko
- Department of Medical and Clinical Genetics, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Applied Tumor Genomics Research Program, Research Programs Unit, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Janne Ravantti
- Department of Medical and Clinical Genetics, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Applied Tumor Genomics Research Program, Research Programs Unit, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, 00014, Helsinki, Finland
| | - Sanna Heikkinen
- Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland
| | - Lauri A Aaltonen
- Department of Medical and Clinical Genetics, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Applied Tumor Genomics Research Program, Research Programs Unit, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland
| | - Janne Pitkäniemi
- Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland. .,Health Sciences Unit, Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland. .,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Institute for Statistical and Epidemiological Cancer Research, Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland.
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Zhou F, Shi J, Fang C, Zou X, Huang Q. Gastric Carcinomas in Young (Younger than 40 Years) Chinese Patients: Clinicopathology, Family History, and Postresection Survival. Medicine (Baltimore) 2016; 95:e2873. [PMID: 26945372 PMCID: PMC4782856 DOI: 10.1097/md.0000000000002873] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Little is known about clinicopathological characteristics of gastric carcinoma (GC) in young (≤40 years) Chinese patients. We aimed in this study to analyze those features along with family history and prognostic factors after resection. We retrospectively reviewed all 4671 GC resections (surgical and endoscopic) performed at our center from 2004 to 2014 and identified 152 (3.2%) consecutive young patients. Patient demographics, clinical results, family history, and endoscopic-pathological findings were analyzed along with the older (>41 years) GC controls recruited in the same study period. Clinicopathological factors related to postresection outcomes were assessed statistically. The trend of GC resections in young patients was not changed over the study period. Compared to old GCs, the young GC cohort was predominant in women, positive family history, middle gastric location, the diffuse histology type, shorter duration of symptoms, and advanced stage (pIII+pIV, 53.3%). Radical resection was carried out in 90.1% (n = 137) with a better 5-year survival rate (70.3%) than palliative surgery (0%, n = 15). There was no significant difference in clinicopathological characteristics between familial GC (FGC, n = 38) and sporadic GC (SGC, n = 114) groups. Very young patients (≤ 30 years, n = 38) showed lower Helicobacter pylori (Hp) infection and significantly higher perineural invasion rates, compared to older (31-40 years) patients. Hp infection was more commonly seen in the Lauren's intestinal type and early pT stages (T1+T2). Independent prognostic factors for worse outcomes included higher serum CA 72-4, CA 125 levels, positive resection margin, and stage pIII-pIV tumors. The 5-year survival rate was significantly higher in patients with radical resection than those without. GCs in young Chinese patients were prevalent in women with advanced stages but showed no significant differences in clinicopathology between FGC and SGC groups. High serum CA 72-4 and CA 125 levels may help identify patients with worse outcomes. Radical resection improved postresection survival.
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Affiliation(s)
- Fan Zhou
- From the Gastroenterology Department (FZ, CF, XZ), Drum Tower Hospital Affiliated to Nanjing University Medical School; Pathology Department (JS, QH), Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, Jiangsu, China; and Pathology Department (QH), VA Boston Healthcare System and Harvard Medical School, Boston, MA
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Worster E, Liu X, Richardson S, Hardwick RH, Dwerryhouse S, Caldas C, Fitzgerald RC. The impact of prophylactic total gastrectomy on health-related quality of life: a prospective cohort study. Ann Surg 2014; 260:87-93. [PMID: 24424140 DOI: 10.1097/sla.0000000000000446] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The advice to individuals with identified CDH1 mutations is generally to undertake prophylactic total gastrectomy (PTG). This study evaluated the effect of PTG on health-related quality of life (HRQL) in asymptomatic individuals with identified CDH1 mutations at high risk for gastric cancer. METHODS Individuals with hereditary diffuse gastric cancer (HDGC) were recruited to a prospective, multicenter UK study. Questionnaires, including the European Organization for Research and Treatment for Cancer core Quality-of-Life Questionnaire (EORTC QLQ C30); the gastric cancer specific module (EORTC QLQ STO22); and the 36-item short form health survey version 2.0, were completed before and at regular intervals after surgery. RESULTS Sixty individuals fulfilled HDGC criteria; 38 (63%) had a CDH1 mutation and 32 (53%) underwent PTG. At baseline, there was no significant difference in mental health depending on CDH1 mutation status and treatment preference. Physical functioning reduced in the first month after surgery but recovered to baseline by 12 months. Similarly mental functioning reduced in the first month after surgery but recovered by 3 to 9 months. However, specific symptoms were identified, such as diarrhoea (70%), fatigue (63%), discomfort when eating (81%), reflux (63%), eating restrictions (45%), and body image (44%), which persisted after PTG. CONCLUSIONS Patients contemplating prophylactic gastrectomy can be reassured about the long-term HRQL outcomes, but some residual symptoms require adjustment.
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Affiliation(s)
- Elizabeth Worster
- *MRC Cancer Unit, University of Cambridge, UK †Department of Oncology, Addenbrooke's Hospital, Cambridge, UK ‡Cambridge Oesophago-Gastric Centre, Addenbrooke's Hospital, Cambridge, UK §Cancer Research UK Cambridge Institute, Cambridge, UK
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