Jefferies S, Goldgar D, Eeles R
Addenbrooke's Hospital, Cambridge, Surrey SM2 5PT, UK.
Clin Oncol (R Coll Radiol). 2008 May;20(4):309-14. doi: 10.1016/j.clon.2008.01.008. Epub 2008 Mar 7.
The assessment of the risk of developing cancer is largely based on family history. This study aimed to confirm as many cancer diagnoses as possible in families of patients with second primary tumours after index squamous cell carcinoma of the head, single squamous cell carcinoma and spouse controls.
Eighty patients with second primary tumours, 67 with single squamous cell carcinoma and 47 spouse controls were recruited into the study. A detailed interview was undertaken on all study participants, including information on all first-degree relatives for causes of death and possible diagnoses of cancer.
Details were available from 1340 first-degree relatives: second primary tumour group 570 relatives, single squamous cell carcinoma 429 relatives and the spouse controls 341 relatives. There were 174 cases of cancer (76, 56 and 42, respectively). For those relatives that had died, submissions were made to the Office of National Statistics to confirm the cause and date of death. One hundred and thirty-three cases were submitted for Office of National Statistics flagging (58, 42 and 33, respectively). Seventy-four of the first-degree relatives with cancer were successfully traced. Tracing confirmed a cancer diagnosis but no further details of the primary site in 31 of the relatives. Thirty-eight of the first-degree relatives were confirmed to have the cancer site of diagnosis reported by the study participants. Thirteen of the reported diagnoses in the first-degree relatives were inaccurate with regard to the cancer site of origin. Five of the first-degree relatives did not have a cancer diagnosis confirmed on the death certificate.
This study highlights the difficulties encountered in confirming cancer diagnoses among first-degree relatives within this cancer site. To improve such studies and our routine collection of data within the clinic setting, more robust systems are needed to interlink cancer registries, population data and hospital records.
癌症发病风险评估很大程度上基于家族病史。本研究旨在尽可能多地确认头颈部原发性鳞状细胞癌患者、单发鳞状细胞癌患者及配偶对照家庭中的癌症诊断情况。
招募了80例患有第二原发性肿瘤的患者、67例患有单发鳞状细胞癌的患者以及47例配偶对照参与本研究。对所有研究参与者进行了详细访谈，包括所有一级亲属的死因及可能的癌症诊断信息。
获取了1340名一级亲属的详细信息：第二原发性肿瘤组570名亲属、单发鳞状细胞癌组429名亲属及配偶对照组341名亲属。共有174例癌症病例（分别为76例、56例和42例）。对于那些已去世的亲属，向国家统计局办公室提交申请以确认死因和死亡日期。向国家统计局办公室提交了133例申请（分别为58例、42例和33例）。成功追踪到74名患有癌症的一级亲属。追踪确认31名亲属患有癌症，但未获取原发部位的进一步详细信息。38名一级亲属被确认患有研究参与者报告的癌症部位。一级亲属报告的诊断中有13例在癌症起源部位方面不准确。5名一级亲属的死亡证明上未确认癌症诊断。
本研究凸显了在该癌症部位的一级亲属中确认癌症诊断所遇到的困难。为改进此类研究以及我们在临床环境中的常规数据收集，需要更强大的系统来连接癌症登记处、人口数据和医院记录。
