Family history of cancer and risk for esophageal and gastric cancer in Shanxi, China

Abstract

BackgroundFamily history (FH) by different relative types and risk of upper gastrointestinal (UGI) cancers has been only rarely reported; the data on UGI cancer survival are sparse.Methods600 esophageal squamous cell carcinoma (ESCC) cases, 598 gastric cardia adenocarcinoma cases, and 316 gastric non-cardia adenocarcinoma cases, and 1514 age-, gender-, and neighborhood-matched controls were asked for FH in first degree relatives and non-blood relatives. Odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regressions, and hazard ratios (HRs) from Cox proportional hazard regressions were estimated.ResultsIncreased ESCC risk was associated with FH of any cancer (OR = 1.72, 95% CI = 1.39–2.12), FH of any UGI cancer (OR = 2.28, 95%CI = 1.77–2.95) and FH of esophageal cancer (OR = 2.84, 95%CI = 2.09–3.86), but not FH of non-UGI cancer. Individuals with two or more affected first-degree relatives had 10-fold increased ESCC risk. FH of gastric cardia cancer was associated with an increased risk of all three cancers. Cancer in non-blood relatives was not associated with risk of any UGI cancer. FH of UGI cancer was associated with a poorer survival rate among younger ESCC cases (HR = 1.82, 95%CI = 1.01–3.29).ConclusionThese data provide strong evidence that shared susceptibility is involved in esophageal carcinogenesis and also suggest a role in prognosis.

Does family history of cancer modify the effects of lifestyle risk factors on esophageal cancer? a population‐based case–control study in China

“…Gao et al reported that the OR with affected father, mother and sibling was 2.01, 3.27 and 4.66, respectively; the risk was greater if more than one FDR was affected. 10 Similar results were reported by Tran et al and Akbari et al 9,11 In agreement with their findings, we observed elevated risk of esophageal cancer among people with affected parents (OR ¼ 2.16) or siblings (OR¼ 2.57) and a 3.14-fold risk if more than one FDR had the same type of cancer. OR for siblings was slightly higher than for parents, indicating that recessive or X-linked susceptibility genes may be important in the development of esophageal cancer, 31 or that siblings share more environmental exposures than children do with their parents.…”

“…10,13,15 A likely aggregation of esophageal cancer with spouses (OR ¼ 1.72; 95% CI ¼ 0.93-3.21) and weak association in probands younger than 50 years old (OR ¼ 1.45; 95% CI ¼ 0.74-2.84) in our analysis also suggested the potential effect of shared exogenous 1 Missing data were excluded from analysis for those variables that the total numbers of cases or controls were less than the total number. 2 p value comparing cases and controls.…”

“…8 Another large case-control study conducted in China (600 cases and 1,514 controls) showed ORs of 1.72 and 2.84 among people with FH-FDR of any malignant tumor and esophageal cancer, respectively. 10 Akbari et al found a hazard ratio of 2.3 among individuals whose FDR was diagnosed with esophageal cancer in Iran. 11 In line with these previous studies, we observed a 1.64-and 2.22-fold risk for FH-FDR of any malignant tumor and esophageal cancer, respectively.…”

“…A positive association was found in highrisk areas such as China and Iran. [8][9][10][11] Chang-Claude et al reported that the standardized mortality ratio of esophageal cancer among people with FH-FDR of this disease was 2.36 in a cohort study in China. 8 Another large case-control study conducted in China (600 cases and 1,514 controls) showed ORs of 1.72 and 2.84 among people with FH-FDR of any malignant tumor and esophageal cancer, respectively.…”

“…Studies of gene-environmental interactions suggest that the risk of environmental and lifestyle factors could be modified by genetic predispositions. 7 Several epidemiological studies have pointed to the familial aggregation of esophageal cancer [8][9][10][11][12] and reported that having a positive family history of esophageal cancer could increase the risk of the disease, with a 2-to 3-fold risk among those with affected first-degree relatives (FDRs) …”