Suzuki Takeshi, Matsuo Keitaro, Wakai Kenji, Hiraki Akio, Hirose Kaoru, Sato Shigeki, Ueda Ryuzo, Tajima Kazuo
Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
Cancer. 2007 May 15;109(10):2116-23. doi: 10.1002/cncr.22685.
Inherited genetic predispositions are important risk factors for the development of cancer in general. To determine genetic susceptibility for 14 common cancers, a case-control study of the impact of a family history of cancer in first-degree relatives was conducted. The authors further evaluated the effect modification by habitual smoking with adjustment for other confounding environmental factors.
In total, 18,836 cancer cases and 28,125 age-matched and sex-matched controls, confirmed as being free of cancer, were recruited. Odds ratios (ORs) and 95% confidence intervals were determined by multiple logistic regression analysis, including stratification by family history for 14 cancer sites and interactions with a smoking history.
The associations between family history and risk of cancer were generally stronger at the same sites than across cancer sites. Risks to first-degree relatives at the same sites were found to be significantly elevated with 8 of 14 cancer sites; especially high ORs were found for prostate and thyroid cancers. Some across-site associations were observed; in particular, a reciprocal association between breast and prostate cancer was found. The interaction between family history and smoking history for breast cancer was found to be statistically significant. There was no statistical evidence for the interactions in other sites, but among subjects with a family history, the ORs were found to be higher in smokers compared with nonsmokers.
The results of the current study support the hypothesis of a genetic susceptibility to cancers in family members. For breast cancer, the interaction between family history and smoking history was observed to be significant.
一般而言,遗传易感性是癌症发生的重要风险因素。为了确定14种常见癌症的遗传易感性,开展了一项关于一级亲属癌症家族史影响的病例对照研究。作者进一步评估了习惯性吸烟对效应的修正作用,并对其他混杂环境因素进行了调整。
共招募了18836例癌症病例和28125例年龄和性别匹配且确诊无癌症的对照。通过多因素logistic回归分析确定比值比(OR)和95%置信区间,包括按14个癌症部位的家族史进行分层以及与吸烟史的交互作用。
家族史与癌症风险之间的关联在相同部位通常比不同癌症部位之间更强。在14个癌症部位中的8个部位,发现同一部位一级亲属的风险显著升高;前列腺癌和甲状腺癌的OR尤其高。观察到一些不同部位之间的关联;特别是发现乳腺癌和前列腺癌之间存在相互关联。发现乳腺癌家族史与吸烟史之间的交互作用具有统计学意义。在其他部位没有交互作用的统计学证据,但在有家族史的受试者中,吸烟者的OR高于不吸烟者。
本研究结果支持家庭成员对癌症具有遗传易感性的假设。对于乳腺癌,观察到家族史与吸烟史之间的交互作用具有显著性。