Hemminki K, Vaittinen P, Kyyrönen P
Department of Biosciences at Novum, Karolinska Institute, Huddinge, Sweden.
Int J Cancer. 1998 Oct 5;78(2):172-5. doi: 10.1002/(sici)1097-0215(19981005)78:2<172::aid-ijc9>3.0.co;2-w.
Quantitative data on familial cancer risks are important for clinical, psychological and scientific reasons. The available estimates carry many uncertainties due to sample size and possible bias in data collection and often refer to first-degree relatives of unspecified age and sex. We calculated sex- and age-specific familial hazard ratios (FHRs) of cancer in offspring aged 15-53 years of cancer probands at 16 male and 17 female cancer sites, based on registered nation-wide data, free from bias. The familial risks in offspring were high, > 5 for thyroid (FHR 10.7 in all offspring, CI 95% 6.9-16.6), and testicular cancer (FHR 5.4, CI 95% 2.6-11.3), or intermediate, FHR 2-5, for colon, rectal, lung, breast, cervical, uterine, ovarian, skin (melanoma and squamous cell) and other endocrine gland cancers. FHRs < 2.0 were observed for stomach, renal and nervous system cancers, lymphomas and leukemias. Some sex differences were observed: FHRs for male breast (only 2 cases) and thyroid cancers were over 2 times higher than the respective female ones. When parents were diagnosed before age 50 years, offspring were at an increased risk of familial breast, renal, skin (melanoma), nervous system, thyroid and non-thyroid endocrine gland cancers, particularly affecting young (< 40 years) individuals. The parental diagnostic age also affected offspring's risk of colon, rectal, uterine and ovarian cancers, but young individuals were not at a particular risk. No effect of age was noted for cervical cancer and lymphoma.
出于临床、心理和科学原因,关于家族性癌症风险的定量数据很重要。由于样本量以及数据收集过程中可能存在的偏差,现有的估计存在许多不确定性,并且通常涉及未指明年龄和性别的一级亲属。我们基于全国范围内无偏差的登记数据,计算了年龄在15 - 53岁的癌症先证者后代中,16种男性癌症部位和17种女性癌症部位的特定性别和年龄的家族性风险比(FHRs)。后代中的家族性风险较高,甲状腺癌(所有后代的FHR为10.7,95%置信区间为6.9 - 16.6)和睾丸癌(FHR为5.4,95%置信区间为2.6 - 11.3)的FHR大于5,或者结肠癌、直肠癌、肺癌、乳腺癌、宫颈癌、子宫癌、卵巢癌、皮肤癌(黑色素瘤和鳞状细胞癌)以及其他内分泌腺癌症的FHR为中等水平,即2 - 5。胃癌、肾癌、神经系统癌症、淋巴瘤和白血病的FHR小于2.0。观察到了一些性别差异:男性乳腺癌(仅2例)和甲状腺癌的FHR比相应的女性FHR高出2倍以上。当父母在50岁之前被诊断出癌症时,后代患家族性乳腺癌、肾癌、皮肤癌(黑色素瘤)、神经系统癌症、甲状腺癌和非甲状腺内分泌腺癌症的风险增加,尤其影响年轻(<40岁)个体。父母的诊断年龄也影响后代患结肠癌、直肠癌、子宫癌和卵巢癌的风险,但年轻个体并非特别易感。未发现年龄对宫颈癌和淋巴瘤有影响。