Colorectal Cancer Epidemiology Group, Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, University of Leeds, Leeds LS9 7TF, UK.
Br J Cancer. 2013 Apr 16;108(7):1502-7. doi: 10.1038/bjc.2013.91. Epub 2013 Mar 19.
Although family history is well established to be a risk factor for developing colorectal cancer (CRC), much less is known about its impact on patient survival. This study aimed to link CRC patient data from the National Study of Colorectal Cancer Genetics (NSCCG) to the National Cancer Data Repository (NCDR) to examine the relationship between family history and the characteristics and outcomes of CRC.
All eligible NSCCG patients underwent a matching process to the NCDR using combinations of their personal identifiers. The characteristics and survival of CRC patients with and without a family history of CRC were compared.
Of the 10 937 NSCCG patients eligible to be matched into the NCDR, 10 782 (98.6%) could be fully linked. There were no significant differences between those with and without a family history of CRC (defined as having at least one affected first-degree relative) in terms of age, sex, tumour stage at diagnosis, presence of multiple cancers, mode of presentation to hospital and surgical management, although patients with familial CRC were more likely to have right-sided tumours (P<0.01). The survival of patients with familial CRC was significantly better than those with sporadic CRC (HR 0.89, 95%CI: 0.81-0.98, P=0.02).
We have demonstrated that it is possible to robustly match patients recruited into the NSCCG into the NCDR and, by using this record linkage, enable genetic data to be related to CRC phenotype, clinical management and outcome. This study provides evidence that a family history of CRC is associated with better survival after a diagnosis of CRC.
虽然家族史已被充分证实是罹患结直肠癌（CRC）的风险因素，但人们对其对患者生存的影响知之甚少。本研究旨在将国家结直肠癌遗传研究（NSCCG）的 CRC 患者数据与国家癌症数据库（NCDR）相链接，以研究家族史与 CRC 的特征和结局之间的关系。
所有符合条件的 NSCCG 患者都通过其个人识别码的组合进行了与 NCDR 相匹配的过程。比较了有和无 CRC 家族史的 CRC 患者的特征和生存情况。
在有资格被匹配到 NCDR 的 10937 名 NSCCG 患者中，有 10782 名（98.6%）能够完全匹配。有和无 CRC 家族史（定义为至少有一个受影响的一级亲属）的患者在年龄、性别、诊断时的肿瘤分期、是否存在多种癌症、就诊方式和手术管理方面无显著差异，尽管家族性 CRC 患者更有可能患有右侧肿瘤（P<0.01）。家族性 CRC 患者的生存明显优于散发性 CRC 患者（HR 0.89，95%CI：0.81-0.98，P=0.02）。
我们已经证明，将 NSCCG 招募的患者与 NCDR 进行可靠匹配，并通过使用这种记录链接，使遗传数据与 CRC 表型、临床管理和结局相关联是可行的。本研究提供的证据表明，CRC 的家族史与 CRC 诊断后的生存改善有关。
