Family history of colorectal cancer as a risk factor for benign and malignant tumours of the large bowel. A case‐control study

Bonelli, Luigina; Martines, H.; Conio, Mássimo; Bruzzi, Paolo; Aste, H.

doi:10.1002/ijc.2910410407

Cited by 119 publications

(48 citation statements)

References 23 publications

(20 reference statements)

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“…Our findings are in broad agreement with other reports of an elevated risk of colorectal cancer in subjects with a family history of CRC (Woolf, 1958;Macklin, 1960;Lovett, 1976;Duncan and Kyle, 1982;Bonelli et al, 1988;Ponz de Leon et al, 1989;Sondergaard et al, 1991;La Vecchia et al, 1992;St. John et al, 1993;Fuchs et al, 1994;Goldgar et al, 1994;Slattery and Kerber, 1994;Carstensen et al, 1996;Le Marchand et al, 1996).…”

Section: Resultssupporting

confidence: 93%

Family history of cancer and risk of colorectal cancer in Italy

Negri

Braga²,

Vecchia³

et al. 1998

Br J Cancer

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Summary Subjects with a family history of colorectal cancer (CRC) are at increased risk of CRC, but quantification of the risk in different populations, the possible differences in risk according to localization of the cancer and the association of family history of other cancers with CRC risk are still open issues. We have therefore analysed data from a multicentric case-control study conducted in six Italian areas between 1992 and 1996 of 1225 incident cases of colon cancer, 728 cases of rectal cancer and 4154 controls admitted for acute conditions to the same network of hospitals as the cases. Unconditional logistic regression models including terms for gender, age, study centre, years of education and number of siblings were used to estimate the odds ratios (ORs) of CRC according to various aspects of history of CRC and other cancers in first-degree relatives. The OR for family history of CRC was 3.2 (95% confidence interval, Cl, 2.5-4.1) for colon cancer and 2.2 (95% Cl 1.6-3.1) for rectal cancer. Colon cancer was significantly associated with a family history of stomach (OR 1.4), bone (OR 2.1) and kidney (OR 2.3) cancers, while rectal cancer was significantly associated with a family history of lymphomas (OR 2.8). There was a 30% higher risk of colon and rectal cancer in subjects with a family history of any cancer, excluding intestine. The ORs for family history of CRC were 5.2 for colon and 6.3 for rectum when the proband's age was below 45 years. The ORs were similar when the affected relative was a parent or a sibling and in different strata of age of relative(s). For subjects with two or more first-degree relatives with CRC, the risk was 6.9 for the right colon, 5.8 for the transverse and descending colon, 3.8 for the sigma, 3.2 for the rectosigmoid junction and 1.9 for the rectum. This study confirms that a family history of CRC in first-degree relatives increases the risk of both colon and rectal cancer, the association being stronger at younger ages and for right colon.

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Section: Resultssupporting

confidence: 93%

Family history of cancer and risk of colorectal cancer in Italy

Negri

Braga²,

Vecchia³

et al. 1998

Br J Cancer

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“…As in previous studies risk was increased among offspring and siblings of CRC patients (Bonelli et al, 1988;Tung and Wu, 2000;Lindgren et al, 2002).…”

Section: Discussionsupporting

confidence: 75%

Association of colorectal adenoma with other malignancies in Swedish families

et al. 2008

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Using the Swedish Family-Cancer Database covering over 11.5 million individuals, estimated relative risks (RRs) for colorectal adenoma were using Poisson's regression. The RR of colorectal adenoma was found to be increased among first-degree relatives of patients with colorectal cancer (2.72; 95% confidence interval ¼ 2.46 -3.00) and among the offspring and siblings of patients with endometrial and prostate cancers. We also found an increased risk of colorectal adenoma for the offspring of individuals with stomach cancer and leukaemia, and for siblings of those with pancreatic cancer and multiple myeloma. Our results suggest that colorectal adenoma may share a genetic aetiology with cancer even at extracolorectal sites. Increases of colorectal adenoma in families affected by prostate cancer and acute leukaemia cannot be attributed to known cancer syndromes, although the play of chance cannot be excluded.

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“…Lastly, having a positive family history for colorectal cancer has been cited as being associated with an increased risk of current colorectal cancer (Bonelli et al, 1988;Slattery et al, 2003). The three included studies assessing family history of colorectal (Whiting et al, 2006) Were all outcome events and predictors clearly defined?…”

Section: Context Of Previous Studiesmentioning

confidence: 99%

Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer

et al. 2009

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BACKGROUND: Rectal bleeding is a recognised early symptom of colorectal cancer. This study aimed to assess the diagnostic accuracy of symptoms, signs and diagnostic tests in patients with rectal bleeding in relation to risk of colorectal cancer in primary care. METHODS: Diagnostic accuracy systematic review. Medline (1966 to May 2009), Embase (1988 to May 2009), British Nursing Index (1991 to May 2009 and PsychINFO (1970 to May 2009 were searched. We included cohort studies that assessed the diagnostic utility of rectal bleeding in combination with other symptoms, signs and diagnostic tests in primary care. An eight-point quality assessment tool was produced to assess the quality of included studies. Pooled positive likelihood ratios (PLRs), sensitivities and specificities were calculated. RESULTS: Eight studies incorporating 2323 patients were included. Average weighted prior probability of colorectal cancer was 7.0% (range: 3.3 -15.4%, median: 8.1%). Age X60 years (pooled PLR: 2.79, 95% confidence interval (CI) 2.00 -3.90), weight loss (pooled PLR: 1.89, 95% CI: 1.03 -3.07) and change in bowel habit (pooled PLR: 1.92, 95% CI: 0.54 -3.57) raise the probability of colorectal cancer into the range of referral to secondary care but do not conclusively 'rule in' the diagnosis. Presence of severe anaemia has the highest diagnostic value (pooled PLR: 3.67, 95% CI: 1.30 -10.35), specificity 0.95 (95% CI: 0.93 -0.96), but still only generates a posttest probability of 21.6%. CONCLUSIONS: In patients with rectal bleeding who present to their general practitioner, additional 'red flag' symptoms have modest diagnostic value. These findings have implications in relation to recommendations contained in clinical practice guidelines.

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Family history of colorectal cancer as a risk factor for benign and malignant tumours of the large bowel. A case‐control study

Cited by 119 publications

References 23 publications

Family history of cancer and risk of colorectal cancer in Italy

Family history of cancer and risk of colorectal cancer in Italy

Association of colorectal adenoma with other malignancies in Swedish families

Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer

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