Abstract
PURPOSE: Estimates of familial colorectal cancer risks are useful in genetic counseling and as a guide to determining entry into screening programs and trials of chemoprevention. Furthermore, they provide an insight into the contribution of the known colorectal cancer genes to the familial risk of the disease. There is a paucity of data about the familial colorectal cancer risk associated with early-onset disease outside the recognized cancer predisposition syndromes. METHODS: This was a retrospective cohort study. The parents and siblings of 205 patients with colorectal cancer aged less than 55 years at diagnosis were studied for mortality and cancer incidence. RESULTS: The overall standardized mortality ratio of colorectal cancer compared with the Northern Irish population was 3.54 (95 percent confidence interval, 2.59–4.79). There was some evidence that a family history of colorectal cancer is associated with a greater risk of colon (4.16; 95 percent confidence interval, 2.83–5.91) rather than rectal cancer (2.62; 95 percent confidence interval, 1.43–4.40). Risks in parents (2.54; 95 percent confidence interval, 1.45–3.72) were lower than in siblings (6.15; 95 percent confidence interval, 3.90–9.23). CONCLUSION: First-degree relatives of patients with early-onset disease are at a marked increase in risk. There is evidence that risks vary depending on the type of affected relative and by the site of colorectal cancer. This information should be considered in formulating screening strategies.
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References
DM Parkin P Pesani J Fetley (1999) ArticleTitleEstimates of the world-wide incidence of twenty-five major cancers in 1990 Int J Cancer 80 827–841
HG Welch LM Schwartz S Wolshing (2000) ArticleTitleAre increasing 5-year survival rates evidence of success against cancer JAMA 283 2975–2978
JB Semmens C Platell TJ Threlfall CD Holman (2000) ArticleTitleA population-based study of the incidence, mortality and outcomes in patients following surgery for colorectal cancer in Western Australia Aust N Z J Surg 70 11–18
RS Houlston (1999) ArticleTitleColorectal cancer screening Crit Rev Oncol Hematol 30 183–187
HJ Jarvinen (1992) ArticleTitleEpidemiology of familial adenomatous polyposis in Finland Gut 33 357–360
HJ Jarvinen M Aarnio H Mustonen et al. (2000) ArticleTitleControlled 15-year trial on screening for colorectal cancer in families with hereditary nonpolyposis colorectal cancer Gastroenterology 118 829–834
LA Cannon-Albright MH Skolnick DT Bishop RG Lee RW Burt (1988) ArticleTitleCommon inheritance of susceptibility to colonic adenomatous polyps and associated colorectal cancers N Engl J Med 319 533–537
RA Kerber ML Slattery JD Potter BJ Caan SL Edwards (1998) ArticleTitleRisk of colon cancer associated with a family history of cancer or colorectal polyps Int J Cancer 78 157–160
DJ St. John FT McDermott JL Hopper EA Debney WR Johnson ES Hughes (1993) ArticleTitleCancer risk in relatives of patients with common colorectal cancer Ann Intern Med 118 785–790
F Kee BJ Collins CC Patterson (1991) ArticleTitlePrognosis in familial non-polyposis colorectal cancer Gut 32 512–516
KE Anderson DF Easton FE Matthews J Peto (1992) ArticleTitleCancer mortality in the first degree relatives of young breast cancer patients Br J Cancer 66 599–602
CS Fuchs EL Giovannucci GA Colditz DJ Hunter FE Speizer WC Willett (1994) ArticleTitleA prospective study of family history and the risk of colorectal cancer N Engl J Med 33 1669–1674
DE Goldgar DF Easton LA Cannon-Albright MH Skolnick (1994) ArticleTitleSystematic population-based assessment of cancer risk in first-degree relatives of cancer probands J Natl Cancer Inst 86 1600–1608
NR Hall DT Bishop BM Stephenson PJ Finan (1996) ArticleTitleHereditary susceptibility to colorectal cancer Dis Colon Rectum 39 739–743
P Maire M Morichau-Beauchant J Drucker MA Barboteau J Barbier C Matuchansky (1988) ArticleTitleFamilial occurrence of cancer of the colon and the rectum Gastroenterol Clin Biol 8 22–27
E Negri C Braga C La Vecchia et al. (1998) ArticleTitleFamily history of cancer and risk of colorectal cancer in Italy Br J Cancer 77 174–179
PA Newcombe JO Taylor A Trentham-Dietz (1999) ArticleTitleInteractions of familial and hormonal risk factors for large bowel cancer in women Int J Epidemiol 28 603–608
ML Slattery RA Kerber (1994) ArticleTitleFamily history of cancer and colon cancer risk J Natl Cancer Inst 86 1618–1626
B Carstensen H Soll-Johanning E Villadsen JO Sondergaard E Lynge (1996) ArticleTitleFamilial aggregation of colorectal cancer in the general population Int J Cancer 68 428–435
B Levin GP Murphy (1992) ArticleTitleRevision in American Cancer Society recommendations for the early detection of colorectal cancer Cancer 42 296–299
SV Hodgson DT Bishop MG Dunlop et al. (1995) ArticleTitleSuggested screening guidelines for familial colorectal cancer J Med Screen 2 45–51
PF Pinsky (2000) ArticleTitleDoes hereditary non-polyposis colorectal cancer explain the observed excess risk of colorectal cancer associated with family history? Epidemiology 11 297–303
M Dunlop S Farrington I Nicholl et al. (2001) ArticleTitlePopulation carrier frequency of hMSH2 and hMLH1 mutations Br J Cancer 83 1643–1645
CM Lewis SL Neuhausen D Daley et al. (1996) ArticleTitleGenetic heterogeneity and unmapped genes for colorectal cancer Cancer Res 56 1382–1388
I Tomlinson N Rahman I Frayling et al. (1999) ArticleTitleInherited susceptibility to colorectal adenomas and carcinomas Gastroenterology 116 789–795
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Johns, L.E., Kee, F., Collins, B.J. et al. Colorectal Cancer Mortality in First-Degree Relatives of Early-Onset Colorectal Cancer Cases. Dis Colon Rectum 45, 681–686 (2002). https://doi.org/10.1007/s10350-004-6267-0
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DOI: https://doi.org/10.1007/s10350-004-6267-0