Department of Cancer Prevention, National Cancer Center / National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
Chin Med Sci J. 2021 Mar 31;36(1):27-34. doi: 10.24920/003789.
Objective To characterize Chinese families in which both parents and at least one child are diagnosed with malignant diseases and provide reference for cancer screening or early detection in people whose both parents are diagnosed with cancer. Methods Medical records of all clients to the center of cancer screening and prevention of the National Cancer Center/Cancer Hospital between January 2008 and February 2018 were screened to select families in which both parents and at least one child were diagnosed with malignant diseases. The cancer profiles of fathers, mothers, sons and daughters, their age distribution at diagnosis, and similarity of cancers between two generations were analyzed. The proportions of each cancer in males and females of the cohort were compared with corresponding data from the National Cancer Center Registry of China (NCCRC) in 2013. Results Totally 135 families were identified from records of 33 200 clients. Proportion of lung cancer in fathers (40/135, 29.6%) and in mothers (38/135, 28.1%) were higher than the national data (23.9% in males and 14.9% in females, respectively). The proportion of breast cancer in daughters (35/109, 32.1%) was higher than that of mothers (14/135, 10.4%) and the national data (17.1%). In 71 father-son pairs of cancer, 46.5% (33/71) were of the same systematic disease, and 16.9% (12/71) were of the same cancer. These two indexes were 31.2% (=34) and 10.1% (=11), respectively in the 109 father-daughter pairs of cancer, 36.6% (=26) and 8.5% (=6) respectively in the 71 mother-son pairs of cancer, and 31.2% (=34) and 20.2% (=20) respectively in the 109 mother-daughter pairs of cancer. Sons were more likely to suffer from cancers originated from the same system as father's cancer than daughters (=4.299, <0.05), and daughters were more likely to suffer from the same cancer as their mother's cancer than sons (=4.506, <0.05). The age (mean ± standard deviation) of the daughters (52.4±12.7) and the sons (59.4±10.9) at diagnosis were significantly younger than the fathers (65.5±12.2) and the mothers (65.7 ±12.5) (all <0.001). Conclusions For people whose both parents are diagnosed as cancer, screening or early detection examinations should cover a full range of cancers rather than the cancers their father and mother have suffered, or cancers stemmed from the same system as their parent's cancers. We suggest screening or early detection program for these special population start earlier than that for the general population, with emphasis on cancers derived from digestive system for males and women-specific cancers, i.e., breast cancer, ovarian cancer, cervical cancer and uterine cancer for females.
目的 分析中国双亲及其至少 1 名子女均患有恶性肿瘤的家庭特征，为双亲均患癌人群的癌症筛查或早诊早治提供参考。
方法 筛选 2008 年 1 月至 2018 年 2 月期间在国家癌症中心/中国医学科学院肿瘤医院防癌体检中心接受防癌体检客户的病历资料，选取双亲及其至少 1 名子女均患有恶性肿瘤的家庭，分析父母、子女的癌症谱及其发病年龄分布，比较两代人群肿瘤的相似性，同时将队列中各癌种在男性和女性中的构成比与同期中国肿瘤登记中心（NCCRC）的数据进行比较。
结果 从 33 200 名客户的记录中筛选出 135 个家庭。父亲（40/135，29.6%）和母亲（38/135，28.1%）中肺癌的比例高于全国数据（男性分别为 23.9%和 14.9%，女性分别为 14.9%和 17.1%）。女儿（35/109，32.1%）中乳腺癌的比例高于母亲（14/135，10.4%）和全国数据（17.1%）。在 71 对父子癌症中，46.5%（33/71）为同系统疾病，16.9%（12/71）为同癌种；在 109 对父女癌症中，这两个指标分别为 31.2%（34/109）和 10.1%（11/109）；在 71 对母子癌症中，这两个指标分别为 36.6%（26/71）和 8.5%（6/71）；在 109 对母女癌症中，这两个指标分别为 31.2%（34/109）和 20.2%（20/109）。与女儿相比，儿子更易患与父亲相同系统的癌症（=4.299，<0.05），而女儿更易患与母亲相同的癌症（=4.506，<0.05）。女儿（52.4±12.7）和儿子（59.4±10.9）的诊断年龄明显低于父亲（65.5±12.2）和母亲（65.7 ±12.5）（均<0.001）。
结论 双亲均患癌人群的癌症筛查或早诊早治范围不应局限于父母所患癌种，或局限于与父母相同系统的癌种，建议为这类特殊人群制定早于一般人群的筛查或早诊早治方案，重点关注消化系统癌症，并对女性强调乳腺癌、卵巢癌、宫颈癌和子宫内膜癌等女性特有的癌症。
