Cancer Risks for Relatives of Patients With Serrated Polyposis

Abstract

OBJECTIVES Serrated polyposis (hyperplastic polyposis) is characterized by multiple polyps with serrated architecture in the colorectum. While patients with serrated polyposis are known to be at increased risk of colorectal cancer (CRC) and possibly extracolonic cancers, cancer risk for their relatives has not been widely explored. The aim of this study was to estimate the risks of CRC and extracolonic cancers for relatives of patients with serrated polyposis. METHODS A cohort of the 1,639 first- and second-degree relatives of 100 index patients with serrated polyposis recruited regardless of a family history of polyps or cancer from genetic clinics in Australia, New Zealand, Canada and the USA, were retrospectively analysed to estimate the country-, age- and sex-specific standardized incidence ratios (SIRs) for relatives compared with the general population. RESULTS A total of 102 CRCs were observed in first- and second-relatives (SIR 2.25, 95% confidence interval, CI 1.75-2.93; P<0.001), with 54 in first-degree relatives (SIR 5.16, 95% CI 3.70-7.30; P<0.001) and 48 in second-degree relatives (SIR 1.38, 95% CI 1.01-1.91; P=0.04). Six pancreatic cancers were observed in first-degree relatives (SIR 3.64, 95% CI 1.70-9.21; P=0.003). There was no statistical evidence of increased risk for cancer of the stomach, brain, breast or prostate. CONCLUSIONS Our finding that relatives of serrated polyposis patients are at significantly increased risk of colorectal and pancreatic cancer, adds to the accumulating evidence that serrated polyposis has an inherited component.

Phenotype Characteristics of Patients With Colonic Serrated Polyposis Syndrome: A Study of 23 Cases

“…6,7 Hyperplastic polyposis syndrome, or rather, serrated polyposis syndrome (SPS) is rare and poorly understood entity; its genetic base is unknown, although it shows characteristics distinctive of diseases with genetic predisposition 8-10 such as colonic serrated polyps, early diagnosis, and greater prevalence conferred to CRC family history. Patients affected by this syndrome carry a high risk (25%-40%) of developing CRC [10][11][12][13] ; sporadic as well as hereditary cases have been reported. [9][10][11] A great rate of extracolonic cancer seems to exist.…”

Editorial: Serrated Polyposis: The Last (or Only the Latest?) Frontier of Familial Polyposis?

“…One must be cognizant of the fact that adenocarcinomas of the pancreas may diff er from both an etiologic and genetic component from non-adenocarcinoma histologic types, such as neuroendocrine types, of pancreatic cancer. Win et al ( 15 ) have given appropriate focus to the pancreatic cancer association in their familial cancer clusters; we believe that further attention to obtain more extended pedigrees, particularly those with pancreatic cancer and, indeed, embracing cancer of all anatomic sites inclusive of serrated adenomas through four or more generations whenever possible will be required to further defi ne the clinical spectrum of SP.…”

“…In this issue of American Journal of Gastroenterology , Win et al ( 15 ) provide important new information in our expanding understanding of SP. Th ese authors gathered clinical information, through genetics clinics in Australia, New Zealand, and North America, on 100 individuals who met the WHO criteria # 1 or # 3 for SP ( Table 1 ) and on over 1,600 of their fi rst-and second-degree relatives.…”

Prevalência de câncer colorretal associado ao papilomavírus humano: uma revisão sistemática com metanálise

“…When the precancerous lesions and lesions linked to cancer are assessed, it is observed that HPV 16 and 18 are responsible for approximately 55% of the cases with high-risk lesions and around 70% of cases of cervical cancer, both in South America and in Brazil 8 . Another risk factor is the genetic predisposition, such as familial adenomatous polyposis or first degree relatives with colorectal cancer 12 . In addition, environmental factors such as smoking, alcohol consumption, and obesity, combined with the elevated consumption of red meat, are also understood as risk factors.…”