Department of Medicine and Therapeutics, Institute of Digestive Disease, Li Ka Shing Institute of Health Sciences, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
Gastroenterology. 2013 Mar;144(3):544-50. doi: 10.1053/j.gastro.2012.11.011. Epub 2012 Nov 13.
BACKGROUND & AIMS: Colorectal cancer (CRC) is the second-most common cancer in Hong Kong. Relatives of patients with CRC have an increased risk of colorectal neoplasm. We assessed the prevalence of advanced neoplasms among asymptomatic siblings of patients with CRC.
Patients with CRC were identified from the Prince of Wales Hospital CRC Surgery Registry from 2001 to 2011. Colonoscopies were performed for 374 siblings of patients (age, 52.6 ± 7.4 y) and 374 age- and sex-matched siblings of healthy subjects who had normal colonoscopies and did not have a family history of CRC (controls, 52.7 ± 7.4 y). We identified individuals with advanced neoplasms (defined as cancers or adenomas of at least 10 mm in diameter, high-grade dysplasia, with villous or tubulovillous characteristics).
The prevalence of advanced neoplasms was 7.5% among siblings of patients and 2.9% among controls (matched odds ratio [mOR], 3.07; 95% confidence interval [CI], 1.5-6.3; P = .002). The prevalence of adenomas larger than 10 mm was higher among siblings of patients than in controls (5.9% vs 2.1%; mOR, 3.34; 95% CI, 1.45-7.66; P = .004), as was the presence of colorectal adenomas (31.0% vs 18.2%; mOR, 2.19; 95% CI, 1.52-3.17; P < .001). Six cancers were detected among siblings of patients; no cancers were detected in controls. The prevalence of advanced neoplasms among siblings of patients was higher when their index case was female (mOR, 4.95; 95% CI, 1.81-13.55) and had distally located CRC (mOR, 3.10; 95% CI, 1.34-7.14).
In Hong Kong, siblings of patients with CRC have a higher prevalence of advanced neoplasms, including CRC, than siblings of healthy individuals. Screening is indicated in this high-risk population. ClinicalTrials.gov number: NCT00164944.
结直肠癌（CRC）是香港第二大常见癌症。CRC 患者的亲属结直肠腺瘤的风险增加。我们评估了无症状 CRC 患者的兄弟姐妹中晚期结直肠肿瘤的发生率。
从 2001 年至 2011 年，我们从威尔斯亲王医院 CRC 外科登记处确定了 CRC 患者。对 374 名患者的兄弟姐妹（年龄 52.6±7.4 岁）和 374 名年龄和性别匹配的健康受试者的兄弟姐妹（对照组，52.7±7.4 岁）进行结肠镜检查。我们确定了具有晚期肿瘤的个体（定义为直径至少 10 毫米的癌症或腺瘤、高级别异型增生、具有绒毛或管状绒毛特征）。
患者的兄弟姐妹中晚期肿瘤的患病率为 7.5%，而对照组为 2.9%（匹配比值比 [mOR]，3.07；95%置信区间 [CI]，1.5-6.3；P=0.002）。与对照组相比，患者的兄弟姐妹中直径大于 10 毫米的腺瘤的患病率更高（5.9% vs 2.1%；mOR，3.34；95%CI，1.45-7.66；P=0.004），以及结直肠腺瘤的存在（31.0% vs 18.2%；mOR，2.19；95%CI，1.52-3.17；P<0.001）。在患者的兄弟姐妹中发现了 6 例癌症，而在对照组中未发现癌症。当指数病例为女性（mOR，4.95；95%CI，1.81-13.55）和 CRC 位于远端时（mOR，3.10；95%CI，1.34-7.14），患者的兄弟姐妹中晚期肿瘤的患病率更高。
在香港，CRC 患者的兄弟姐妹中晚期肿瘤（包括 CRC）的患病率高于健康个体的兄弟姐妹。在高危人群中需要进行筛查。临床试验注册号：NCT00164944。
