Survival in common cancers defined by risk and survival of family members

Abstract

Studies on survival between familial and sporadic cancers have been inconclusive and only recent data on a limited number of cancers are available on the concordance of survival between family members. In this review, we address these questions by evaluating the published and unpublished data from the nation-wide Swedish Family-Cancer Database and a total of 13 cancer sites were assessed. Using sporadic cancer as reference, HRs were close to 1.0 for most of the familial cancers in both the offspring and parental generations, which suggested that survival in patients with familial and sporadic cancers was equal, with an exception for ovarian cancer with a worse prognosis. Compared to offspring whose parents had a poor survival, those with a good parental survival had a decreased risk of death for most cancers and HR was significantly decreased for cancers in the breast, prostate, bladder, and kidney. For colorectal and nervous system cancers, favorable survival between the generations showed a borderline significance. These data are consistent in showing that both good and poor survival in certain cancers aggregate in families. Genetic factors are likely to contribute to the results. These observations call for intensified efforts to consider heritability in survival as one mechanism regulating prognosis in cancer patients.

Is Family History Associated With Improved Survival in Patients With Gastric Cancer?

“…However, the extensive literature on the attempts to associate familial risk with survival has remained largely inconclusive, which we have assumed to depend on different genetic and environmental risk factors for cancer susceptibility and survival. 4,13 The data summarized for 13 different cancers analyzed using the Swedish Family-Cancer Database found consistent association between family history and survival for ovarian cancer only; the hazard ratio for survival was 1.4 in women with a family history of ovarian cancer. 4…”

“…4,13 The data summarized for 13 different cancers analyzed using the Swedish Family-Cancer Database found consistent association between family history and survival for ovarian cancer only; the hazard ratio for survival was 1.4 in women with a family history of ovarian cancer. 4…”

“…However, conflicting results have previously been reported from countries with both low and high prevalence of gastric cancer. [2][3][4] Our previous study, which was carried out using the nationwide Swedish Family-Cancer Database, the world's largest database of family cancer, found an equal survival experience for patients with a family history of gastric cancer and those lacking a family history; the hazard ratios were 0.95 (95% CI, 0.71 to 1.27; n ϭ 91; deaths resulting from gastric cancer, 61) for offspring with an affected parent and 1.06 (95% CI, 0.88 to 1.29; n ϭ 91; deaths resulting from gastric cancer, 73) for parents with an affected offspring compared with patients with no family history of gastric cancer.…”