Fuchs C S, Giovannucci E L, Colditz G A, Hunter D J, Speizer F E, Willett W C
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.
N Engl J Med. 1994 Dec 22;331(25):1669-74. doi: 10.1056/NEJM199412223312501.
A family history of colorectal cancer is recognized as a risk factor for the disease. However, as a result of the retrospective design of prior studies, the strength of this association is uncertain, particularly as it is influenced by characteristics of the person at risk and the affected family members.
We conducted a prospective study of 32,085 men and 87,031 women who had not previously been examined by colonoscopy or sigmoidoscopy and who provided data on first-degree relatives with colorectal cancer, diet, and other risk factors for the disease. During the follow-up period, colorectal cancer was diagnosed in 148 men and 315 women.
The age-adjusted relative risk of colorectal cancer for men and women with affected first-degree relatives, as compared with those without a family history of the disease, was 1.72 (95 percent confidence interval, 1.34 to 2.19). The relative risk among study participants with two or more affected first-degree relatives was 2.75 (95 percent confidence interval, 1.34 to 5.63). For participants under the age of 45 years who had one or more affected first-degree relatives, the relative risk was 5.37 (95 percent confidence interval, 1.98 to 14.6), and the risk decreased with increasing age (P for trend, < 0.001).
A family history of colorectal cancer is associated with an increased risk of the disease, especially among younger people.
结直肠癌家族史被认为是该病的一个风险因素。然而，由于既往研究的回顾性设计，这种关联的强度尚不确定，特别是因为它受到高危人群和受影响家庭成员特征的影响。
我们对32085名男性和87031名女性进行了一项前瞻性研究，这些人此前未接受过结肠镜检查或乙状结肠镜检查，且提供了有关患结直肠癌的一级亲属、饮食及该病其他风险因素的数据。在随访期间，148名男性和315名女性被诊断患有结直肠癌。
与无该病家族史的男性和女性相比，有患癌一级亲属的男性和女性结直肠癌的年龄调整相对风险为1.72（95%置信区间为1.34至2.19）。有两名或更多患癌一级亲属的研究参与者的相对风险为2.75（95%置信区间为1.34至5.63）。对于45岁以下有一名或更多患癌一级亲属的参与者，相对风险为5.37（95%置信区间为1.98至14.6），且风险随年龄增长而降低（趋势P值<0.001）。
结直肠癌家族史与该病风险增加相关，尤其是在年轻人中。
