Maul John Scott, Burt Randall W, Cannon-Albright Lisa A
Department of Medical Oncology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Clin Gastroenterol Hepatol. 2007 Sep;5(9):1080-4. doi: 10.1016/j.cgh.2007.04.025. Epub 2007 Jul 10.
BACKGROUND & AIMS: The Utah Population Database (UPDB) is unique; it links genealogy for over 2 million Utah individuals to a statewide Cancer Registry. We have investigated the familial nature of rectal cancer, considered independently from colon cancer.
We estimated relative risks in relatives, and average relatedness among rectal cancer patients using matched controls from the UPDB.
There is a significant increased risk for rectal cancer in first-degree relatives of rectal cancer patients (relative risk [RR], 1.97), equivalent to the risk for colon cancer (RR, 2.11). The significant increased risk for rectal cancer extends to second- and third-degree relatives. The RR for rectal cancer among first-degree relatives of young-onset rectal cancer patients (<55 y), is equivalent (RR, 3.34) to their risk of colon cancer (RR, 3.35).
The UPDB provides strong evidence for a familial component to rectal cancer that may include a genetic component in addition to shared environment. There is a significant increased risk of rectal cancer in the close and distant relatives of rectal cancer patients, which is even higher among relatives of young-onset patients. Although it has been reported that relatives of colon cancer probands are at increased risk for colorectal cancer, the risk of large-bowel cancer among relatives of rectal cancer patients has been less clear. Relatives of rectal cancer probands experience a risk of cancer of the large bowel that is at least as high as the risk previously reported for relatives of individuals with colon cancer.
犹他州人口数据库(UPDB)独具特色;它将200多万犹他州居民的家谱信息与全州癌症登记处相连接。我们对直肠癌的家族特性进行了研究,将其与结肠癌分开考虑。
我们利用UPDB中匹配的对照,估算了亲属中的相对风险以及直肠癌患者之间的平均亲缘关系。
直肠癌患者的一级亲属患直肠癌的风险显著增加(相对风险[RR],1.97),与患结肠癌的风险相当(RR,2.11)。直肠癌风险的显著增加延伸至二级和三级亲属。年轻发病的直肠癌患者(<55岁)的一级亲属患直肠癌的RR(3.34)与其患结肠癌的风险(RR,3.35)相当。
UPDB为直肠癌的家族因素提供了有力证据,这可能包括遗传因素以及共同的环境因素。直肠癌患者的近亲和远亲患直肠癌的风险显著增加,在年轻发病患者的亲属中这一风险更高。尽管有报道称结肠癌先证者的亲属患结直肠癌的风险增加,但直肠癌患者亲属患大肠癌的风险尚不清楚。直肠癌先证者的亲属患大肠癌的风险至少与先前报道的结肠癌患者亲属的风险一样高。