Family history as a marker of risk for colorectal cancer: Austrian experience

Abstract

A family history of colorectal cancer is a known risk factor for the disease. As a result of different study designs from different populations, the strength of this association varies in the literature. We intended to define the incidence and the risk predictors in first-degree relatives of patients with colorectal cancer in the Austrian population. A family history was obtained from first-degree relatives of 100 consecutive patients with sporadic colorectal cancer. Life-table methods were used to compare the observed and expected incidence of colorectal cancer and the influence of differences in risk for first-degree family members. The calculated lifetime risk for colorectal cancer in Austria is 1:16. Individuals with a positive family history had a 4.6-fold risk (p </= 0.0001), particularly in the case of a young index patient (p </= 0.011) or if two or more family members were affected (p </= 0. 001). In addition, the risk for gastric cancer in relatives was increased almost fourfold (p </= 0.0001). We have confirmed for Austria that a positive family history of colorectal cancer is a strong risk factor, and that this risk is comparable to that in other Western countries. We have shown that relatives are also at increased risk for gastric cancer.

Effects of Family History on Relative and Absolute Risks for Colorectal Cancer: A Systematic Review and Meta-Analysis

“…Characteristics of selected studies are summarized in Supplementary Tables 2 and 3. Among these, 23 studies were conducted in Europe, 17,18,20,[24][25][26]29,31,34,36,37,39,40,42,46,57,59,60,[63][64][65]71,77 18 in the Asia-Pacific nations, 19,23,32,38,45,47,49,50,52,[54][55][56]62,66,70,72,74,76 and 21 in America. 21,22,27,28,30,33,35,41,43,44,…”

Measures of familial aggregation depend on definition of family history: meta-analysis for colorectal cancer

“…The main characteristics of the studies are presented in Table 2. Publication dates ranged over three decades: 6 articles were published in the 1980s, with the earliest published in 1982 [22,28,47,48,56,60]; 21 articles were published in the 1990s [23,24,26,27,[29][30][31]44,45,[49][50][51][52]54,55,[57][58][59]62,64,65]; the remainder were published between 2000 and 2003 [42,43,46,53,61,63]. Thirteen studies were conducted in Europe [22,23,31,42,44,45,47,49,52,54,[56][57][58], 12 in the United States [24,26,…”

“…Twenty-six studies adopted the type I approach to present their findings; 2 of the studies followed up the cohort of probands comparing the incidence of CRC in those with a family history of CRC with the incidence in those with no family history of CRC [50,64]; the other 24 studies analyzed the data from a case-control perspective [22][23][24][27][28][29]31,43,[45][46][47][48][49]51,53,54,56,[58][59][60][61][62][63]65]. Five studies adopted the type II approach to present their findings; two analyzed the data from a case-control perspective [55,57] and three from a cohort perspective, comparing the incidence of CRC in the cohort of relatives of cases with the incidence in the population from which the cases were derived [42,44,52]. Two studies presented both type I and type II estimates, analyzing the data from the case-control perspective [30] and from a case-control and kin-cohort perspective [26].…”

A systematic review and meta-analysis of familial colorectal cancer risk

“…Five studies presented results for relatives of cases diagnosed before age 45 (21,26,(33)(34)(35) (Fig. 3), five presented RRs in relatives of cases diagnosed between age 45 and age 59 (21,26,29,34,36), and three provided estimates of the risk of colorectal cancer in relatives of cases aged Ͼ59 yr at time of diagnosis (13,26,29,33). Combining studies, the summary RR of colorectal cancer is 3.87 (95% CI ϭ 2.40 -6.22) in relatives of cases diagnosed before age 45, 2.25 (95% CI ϭ 1.85-2.72) in relatives of cases diagnosed between ages 45 and 59, and 1.82 (95% CI ϭ 1.47-2.25) in relatives of cases aged Ͼ59 at diagnosis.…”