Influence of family history on survival in patients with colon and rectal cancer

Lee, Seong Dae; Kim, Jae Hak; Han, Kyung Su; Hong, Chang Won; Sohn, Dae Kyung; Park, Ji Won; Park, Sung Chan; Kim, Sun Young; Baek, Ji Eun; Chang, Hee Jin; Kim, Dae Yong; Oh, Jae Hwan

doi:10.1111/1751-2980.12120

Cited by 11 publications

(17 citation statements)

References 24 publications

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“…In five of these, a positive family history of CRC was associated with better survival in CRC patients [6,9,[11][12][13][14]. Two studies indicated higher mortality [8,15], and six studies found no association between CRC family history and survival in CRC patients [5,7,9,10,16,17], although Slattery et al [7] did find a higher mortality for men under age 55 with a positive family history of CRC. Only one small study (N = 318) [12] verified the FDR's cancer diagnoses as reported by the patients, the rest relied solely on self-report of cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Three studies [12,14,16] did this by excluding patients with self-reported family history fulfilling the Amsterdam criteria. Two studies found a better survival in CRC patients with a family history of CRC: RR = 0.37 (0.17, 0.78) and HR 0.760 (0.580, 0.997), respectively [12,14].…”

Section: Discussionmentioning

confidence: 99%

“…In the original study, a total of 1514 patients were diagnosed with primary CRC in the study period. 116 patients (7.7 %) were excluded due to severe illness or death shortly after diagnosis (median survival time after diagnosis was 6 days), and additionally 70 patients (4.6 %) were excluded for psychological reasons (depression, psychosis, senility, or mental disability) [16]. 1200 out of 1328 eligible patients completed the questionnaire (90 %).…”

Section: Study Population and Designmentioning

confidence: 99%

“…Whether family history of CRC affects survival of CRC patients in general has been investigated in numerous studies with conflicting results [5][6][7][8][9][10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Survival in familial colorectal cancer: a Danish cohort study

et al. 2015

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The monogenic Lynch syndrome (LS) is associated with better survival in colorectal cancer (CRC) patients. Whether family history of CRC affects CRC prognosis in general remains unclear. We evaluated overall mortality in a Danish cohort of CRC patients comparing patients with a family history (FHpos) to those without (FHneg) with focus on patients from non-syndromic families, thus FHpos patients were further divided into a non-syndromic group (FHNS) and a HNPCC/LS group (FHHNPCC). We included CRC patients diagnosed 1995-1998. First degree relatives were identified using Danish population registries and family history was obtained by linkage to Danish medical registries. 1- and 5-year mortality were evaluated using the Kaplan-Meier method and Cox regression, with adjustment for age, sex, cancer site, cancer stage, and comorbidity. 1196 CRC patients were included in the study, 219 FHpos patients of whom 197 were FHNS patients. 1- and 5-year adjusted Mortality Rate Ratios comparing FHpos patients to FHneg patients were 0.99 (95% CI 0.69, 1.42) and 1.07 (95% CI 0.87, 1.32), respectively. For FHNS patients, the corresponding MRRs were 1.01 (95% CI 0.69, 1.47) and 1.15 (95% CI 0.93, 1.43). For the FHHNPCC patients MRRs were 0.84 (95% CI 0.29, 2.44) and 0.66 (95% CI 0.33, 1.31), respectively. In contrast to the lower mortality in LS patients, other types of familial CRC do not seem to affect the survival after CRC diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Population and Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Survival in familial colorectal cancer: a Danish cohort study

et al. 2015

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“…CRC in subjects with a family history seems to have a better prognosis, with a greater overall 5-year survival rate and an 11% reduction in the risk of death compared with those with no family history [15] . Further studies support a better prognosis in patients with a family history of CRC [16,17] . The reason for the survival advantage associated with familial CRC is not known.…”

Section: Introductionmentioning

confidence: 79%

Familial colorectal cancer screening: When and what to do?

Blanco¹,

Paoluzi²,

Sileri³

et al. 2015

WJG

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Colorectal cancer (CRC) is the third leading cause of death worldwide and represents a clinical challenge. Family members of patients affected by CRC have an increased risk of CRC development. In these individuals, screening is strongly recommended and should be started earlier than in the population with average risk, in order to detect neoplastic precursors, such as adenoma, advanced adenoma, and nonpolypoid adenomatous lesions of the colon. Fecal occult blood test (FOBT) is a non invasive, widespread screening method that can reduce CRC-related mortality. Sigmoidoscopy, alone or in addition to FOBT, represents another screening strategy that reduces CRC mortality. Colonoscopy is the best choice for screening highrisk populations, as it allows simultaneous detection and removal of preneoplastic lesions. The choice of test depends on local health policy and varies among countries. Core tip: One-fifth of people who develop colorectal cancer (CRC) have a first-degree relative (FDR) affected by this malignancy. Screening is an efficient method to reduce mortality for CRC and should be started in FDRs earlier than in the population at average risk. There is a large disparity in guidelines for screening in familial CRC, therefore, here we address the principal indication and methods for screening in this population at increased risk. Recent or emerging methods to improve the participation rate in screening programs are described. Ongoing trials on CRC screening are also reported.

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Association of family history and survival in patients with colorectal cancer: a pooled analysis of eight epidemiologic studies

et al. 2018

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A family history of colorectal cancer (CRC) in first‐degree relatives (FDRs) increases the risk of CRC. However, the influence of family history on survival among CRC patients remains unclear. We conducted a pooled analysis of survival in 5010 incident CRC cases. Cox proportional hazards models were used to estimate the association of family history with overall survival (OS) and CRC‐specific survival (CSS). We also assessed the impact of the number of affected FDRs and age at CRC diagnosis in the affected FDRs on survival. Among CRC cases, 819 (16%) patients reported a family history of CRC. There were 1580 total deaths over a median follow‐up of 4.6 years, of which 1046 (66%) deaths were due to CRC. Having a family history of CRC was not associated with OS [hazard ratio (HR), 1.03; 95% confidence interval (CI), 0.89–1.19] or CSS (HR, 1.13; 95% CI, 0.95–1.36)]. There were no associations between the number of affected relatives or age at CRC diagnosis of the affected relative with survival (all P trend > 0.05). However, a family history of CRC did confer worse CSS in patients diagnosed with distal colon cancer (HR, 1.45, 95% CI, 1.03–2.04). A family history of CRC was generally not associated with survival after CRC diagnosis. However, having a family history of CRC was associated with worse CRC prognosis in individuals with distal colon cancer, suggesting a possible genetic predisposition with distinct pathogenic mechanism that may lead to worse survival in this group.

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Influence of family history on survival in patients with colon and rectal cancer

Abstract: In patients with stage III CRC, tumor location (especially in the rectum), a high preoperative CEA level and advanced T and N stages indicate a poor prognosis. However, in stage III colon cancer FH is associated with improved survival.

Cited by 11 publications

References 24 publications

Survival in familial colorectal cancer: a Danish cohort study

Survival in familial colorectal cancer: a Danish cohort study

Familial colorectal cancer screening: When and what to do?

Association of family history and survival in patients with colorectal cancer: a pooled analysis of eight epidemiologic studies

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