家族性结直肠癌风险可能低于此前预期：一项丹麦队列研究。

Familial colorectal cancer risk may be lower than previously thought: a Danish cohort study.

作者信息

Lautrup Charlotte K, Mikkelsen Ellen M, Lash Timothy L, Katballe Niels, Sunde Lone

机构信息

Department of Clinical Genetics, Aarhus University Hospital, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Denmark; Department of Clinical Genetics, Aalborg University Hospital, Denmark; The HNPCC Register, Clinical Research Center, Copenhagen University Hospital, Denmark.

Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.

出版信息

Cancer Epidemiol. 2015 Oct;39(5):714-9. doi: 10.1016/j.canep.2015.07.004. Epub 2015 Jul 26.

DOI:10.1016/j.canep.2015.07.004

PMID:26223561

Abstract

BACKGROUND

The risk of colorectal cancer (CRC) is reportedly increased two-fold if at least one first-degree relative (FDR) is affected with CRC, increasing to three- to four-fold if multiple FDRs are affected or if one FDR was diagnosed at a young age. We evaluated familial risk of CRC, systematically excluding monogenetic high-risk families with polyposis or Lynch syndrome/hereditary non-polyposis colorectal cancer (HNPCC).

METHODS

FDRs of 1196 Danish CRC patients diagnosed between 1995 and 1998 (baseline) were identified and the family history of cancer was assessed at baseline using Danish medical registries; 4182 FDRs without CRC from 1060 of the families were matched on age and gender with ten individuals from the general population and followed from baseline to 2010. Family history was updated with any new cancer event during follow-up.

RESULTS

Using Cox proportional hazard modeling the risk estimates were: at least one relative with CRC: hazard ratio (HR)=1.78 (95%CI: 1.45, 2.17), one relative with CRC diagnosed after the age of 50: HR=1.68 (95%CI: 1.32, 2.14), one relative with CRC diagnosed before the age of 50: HR=1.86 (95%CI: 0.70, 4.94), and multiple affected relatives: HR=2.04 (95%CI: 1.38, 3.00).

CONCLUSION

Although the overall risk in FDRs of CRC patients in our study was comparable with the results of previous studies, the risk in families with multiple relatives with CRC or one CRC patient diagnosed young may be lower than reported previously.

摘要

背景

据报道，如果至少有一位一级亲属（FDR）患结直肠癌（CRC），患CRC的风险会增加两倍；如果有多位FDR患病或有一位FDR在年轻时被诊断出患CRC，风险会增加到三到四倍。我们评估了CRC的家族风险，系统地排除了患有息肉病或林奇综合征/遗传性非息肉病性结直肠癌（HNPCC）的单基因高风险家族。

方法

确定了1995年至1998年（基线）期间诊断出的1196例丹麦CRC患者的FDR，并在基线时使用丹麦医疗登记处评估癌症家族史；从1060个家庭中选取4182名无CRC的FDR，按年龄和性别与10名普通人群个体进行匹配，并从基线随访至2010年。随访期间如有任何新的癌症事件，更新家族史。

结果

使用Cox比例风险模型，风险估计值如下：至少有一位亲属患CRC：风险比（HR）=1.78（95%置信区间：1.45，2.17）；有一位亲属在50岁后被诊断出患CRC：HR=1.68（95%置信区间：1.32，2.14）；有一位亲属在50岁前被诊断出患CRC：HR=1.86（95%置信区间：0.70，4.94）；有多位患病亲属：HR=2.04（95%置信区间：1.38，3.00）。