Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Medicine (Gastroenterology), University of Utah, Salt Lake City, Utah.
Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah; Department of Population Sciences, University of Utah, Salt Lake City, Utah.
Clin Gastroenterol Hepatol. 2015 Dec;13(13):2305-11.e1-2. doi: 10.1016/j.cgh.2015.06.040. Epub 2015 Jul 16.
BACKGROUND & AIMS: It is not clear whether familial risk of colorectal cancer (CRC) varies with age of index CRC patients or their relatives. We quantified the risk of CRC in first-degree relatives (FDRs), second-degree relatives, and first-cousin relatives of individuals with CRC, stratified by ages and sexes of index patients and ages of relatives.
CRCs diagnosed between 1980 and 2010 were identified from the Utah Cancer Registry and linked to pedigrees from the Utah Population Database. Age- and sex-matched CRC-free individuals were selected to form the comparison group. CRC risk in relatives was determined by Cox regression analysis.
Of 18,208 index patients diagnosed with CRC, the highest familial risk was observed in FDRs of index CRC patients who were diagnosed at an age younger than 40 years (hazard ratio [HR], 2.53; 95% confidence interval [CI], 1.7-3.79). However, familial risk was increased in FDRs even when the index case was diagnosed with cancer at an advanced age (>80 years; HR, 1.76; 95% CI, 1.59-1.94). Ages of relatives and ages of index cases of CRC each affected familial cancer risk; the highest risk was found in young relatives (<50 years) of individuals with early-onset CRC (<40 years; HR, 7.0; 95% CI, 2.86-17.09).
All relatives of individuals with CRC are at increased risk for this cancer, regardless of the age of diagnosis of the index patient. Although risk is greatest among young relatives of early-onset CRC cases, relatives of patients diagnosed at advanced ages also have an increased risk.
结直肠癌（CRC）的家族发病风险是否随CRC 患者及其亲属的年龄而变化尚不清楚。我们定量评估了CRC 患者的一级亲属（FDR）、二级亲属和表亲患 CRC 的风险，按指数患者的年龄和性别以及亲属的年龄进行分层。
从犹他州癌症登记处确定了 1980 年至 2010 年间诊断的 CRC，并与犹他州人口数据库中的家谱相关联。选择年龄和性别匹配的无 CRC 个体作为对照组。通过 Cox 回归分析确定亲属的 CRC 风险。
在 18208 名诊断为 CRC 的指数患者中，FDR 患 CRC 的家族风险最高，指数 CRC 患者的诊断年龄小于 40 岁（风险比[HR]，2.53；95%置信区间[CI]，1.7-3.79）。然而，即使指数病例诊断为年龄较大（>80 岁；HR，1.76；95% CI，1.59-1.94）的癌症，FDR 的家族风险也会增加。亲属的年龄和 CRC 指数病例的年龄都影响家族癌症风险；在早发性 CRC（<40 岁；HR，7.0；95% CI，2.86-17.09）患者的年轻亲属（<50 岁）中发现风险最高。
CRC 患者的所有亲属患这种癌症的风险均增加，而与指数患者的诊断年龄无关。尽管早发性 CRC 病例的年轻亲属的风险最大，但诊断年龄较大的患者的亲属也有更高的风险。
