Lower Relative Contribution of Positive Family History to Colorectal Cancer Risk with Increasing Age: A Systematic Review and Meta-Analysis of 9.28 Million Individuals

Wong, Martin C.S.; Chan, Celia H. Y.; Lin, Jiayan; Huang, Jason; Huang, Junjie; Fang, Yuan; Cheung, Wai W.; Yu, Chengbo; Wong, John; Tse, Gary; Wu, Justin C.; Chan, Francis K.L.

doi:10.1038/s41395-018-0075-y

Cited by 44 publications

(34 citation statements)

References 80 publications

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“…We showed in this systematic review and metaanalysis that the risk of developing CRC in individuals with a FH of CRC is lower than previously reported, especially according to cohort studies. 4,[79][80][81] RRs at least doubled for individuals having at least 1 FDR with CRC based on case-control studies, and almost tripled for those with at least 2 FDRs with CRC and with a FDR diagnosed with CRC before the age of 50 years. Moreover, AR estimates showed that the risk of developing CRC between 40 and 50 years was low and gradually increased at the age of 50, providing rationale for surveillance recommendations from this age onward.…”

Section: Discussionmentioning

confidence: 99%

“…[79][80][81] A more recent meta-analysis showed lower RR estimates (RR, 1.76; 95% CI, 1.57-1.97). 4 However, these previously published meta-analyses had some drawbacks and limitations: summary estimates consisted of both case-control and cohort studies, none of the studies except the study by Butterworth et al 79 addressed ARs, and the role of the inclusion of individuals with Lynch syndrome was not investigated.…”

Section: Discussionmentioning

confidence: 99%

“…3 A recent systematic review and meta-analysis showed that the relative risk (RR) in first-degree relatives (FDRs) of developing CRC was lower than previously reported. 4 Data on the anticipated risk for second-degree relatives (SDRs) and third-degree relatives (TDRs) were not reported. Furthermore, data on case-control and cohort studies were combined and estimates of absolute risk (AR) for CRC were lacking, although important when informing individuals about their risk.…”

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confidence: 99%

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

Roos

Mangas-Sanjuán

Rodríguez-Girondo

et al. 2019

Clinical Gastroenterology and Hepatology

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This article has an accompanying continuing medical education activity, also eligible for MOC credit, on page e159. Learning Objective-Upon completion of this activity, successful learners will be able to identify the risk for developing colorectal cancer (CRC) related to the type of family history; identify the absolute risk for developing colorectal cancer for individuals with at least one first degree relative (FDR) with CRC younger than 50 years; and define "familial colorectal cancer." BACKGROUND & AIMS: Guidelines recommend that individuals with familial colorectal cancer undergo colonoscopy surveillance instead of average-risk screening. However, these recommendations vary widely. To substantiate appropriate surveillance strategies, precise and valid evidence-based risk estimates are needed for individuals with a family history of colorectal cancer (CRC). METHODS: We systematically searched MEDLINE, EMBASE, and Cochrane from inception to July 2018 for case-control and cohort studies investigating the effect of family history on CRC risk. We calculated summary estimates of pooled relative risks (RRs) using a random-effects model. Life tables were created to convert RR estimates into absolute risk estimates. RESULTS: We screened 4417 articles and identified 42 eligible case-control and 20 cohort studies. In case-control studies, the RR for CRC in patients with 1 first-degree relative (FDR with CRC) was 1.92 (95% CI, 1.53-2.41) and 1.37 (95% CI, 0.76-2.46) for cohort studies. For individuals with 2 or more FDRs with CRC, the RR was 2.81 in case-control studies (95% CI, 1.73-4.55) and 2.40 in cohort studies (95% CI, 1.76-3.28). For individuals having a FDR diagnosed with CRC at an age younger than 50 years, the RR for CRC in their FDRs was 3.57 in case-control studies (95% CI, 1.07-11.85) and 3.26 in cohort studies (95% CI, 2.82-3.77). The cumulative absolute risks for CRC at 85 years in Western Europe were 4.8% for persons with 1 FDR with CRC (95% CI, 2.7%-8.3%), 8.2% for individuals with 2 or more FDRs (95% CI, 6.1%-10.9%), and 11% for persons with a FDR diagnosed with CRC at an age younger than 50 years (95% CI, 9.5%-12.4%). CONCLUSIONS: In this systematic review and meta-analysis, we found that the RR of CRC among FDRs is lower than previously expected, especially based on cohort studies. Risk estimates are affected by the number of relatives with CRC and their age at diagnosis. Intensified colonoscopy surveillance strategies could be considered for high-risk groups. PROSPERO trial identification no: CRD42018103058.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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

Roos

Mangas-Sanjuán

Rodríguez-Girondo

et al. 2019

Clinical Gastroenterology and Hepatology

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“…Previous meta‐analyses have reported that stomach, colorectal, liver, pancreas, lung and breast cancers with FH of concordant cancer were associated with an increased risk compared to those without FH. In contrast, prostate cancer with FH of prostate cancer was not associated with an increased risk .…”

Section: Discussionmentioning

confidence: 97%

Family history of cancer and subsequent risk of cancer: A large‐scale population‐based prospective study in Japan

Hidaka¹,

Sawada²,

Svensson

et al. 2019

Intl Journal of Cancer

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Family history (FH) of cancer is an important factor of increased risk of several cancers. Although the association between FH of cancer and concordant cancer risk has been reported in many previous epidemiological studies, no comprehensive prospective study with adjustment for lifestyle habits has evaluated the association of FH of cancer and concordant cancer risk. We investigated the association between FH of cancer and concordant cancer risk in a Japanese population-based prospective study, initiated in 1990 for cohort I and in 1993 for cohort II. We analyzed data on 103,707 eligible subjects without a history of cancer who responded to a self-administered questionnaire including FH of cancer at baseline. Study subjects were followed through 2012 and analyzed using multivariable-adjusted Cox proportional hazards regression models. During 1,802,581 person-years of follow-up, a total of 16,336 newly diagnosed cancers were identified. Any site (Hazard ratios = 1.11 (95% confidence interval = 1.07-1.15]), esophagus (2.93 [1.06-3.51]) and bladder cancers (6.06 [2.49-14.74]) with FH of the concordant cancer were associated with an increased risk compared to those without FH. Our findings suggest that having FH of cancer is associated with an increased risk of several concordant cancer incidences in an Asian population. Enquiring about FH of several types of cancer may be important in identifying groups at high-risk of those cancers.

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“…A recent meta-analysis showed that a family history of CRC increased risk of CRC by 3.3 times in young individuals aged < 40 years. 23 Finally, we could not investigate the agespecific risk of NAA or ACRN in detail among individuals aged ≥ 66 years because the sample size of the age group was relatively small. Therefore, extrapolating our results to ages 66 years or older should be done with caution.…”

Section: Discussionmentioning

confidence: 99%

Impact of family history of colorectal cancer on age‐specific prevalence of colorectal neoplasia

Park

Kim

Park

et al. 2018

J of Gastro and Hepatol

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Background and Aim There are no established guidelines on screening strategies for persons with a family history of colorectal cancer (CRC) in Korea. We aimed to evaluate the age‐specific risk of colorectal neoplasia according to family history of CRC. Methods Participants who underwent screening colonoscopy were included. Age‐specific prevalence of non‐advanced adenoma (NAA) and advanced colorectal neoplasia (ACRN) was calculated according to family history of CRC. Results Among 35 997 participants, 1339 (3.7%) had a family history of CRC in first‐degree relatives. A family history of CRC was an independent risk factor for NAA (adjusted odds ratio [AOR] 1.33, 95% confidence interval [CI] 1.16–1.52). In the subgroup analysis by age, family history of CRC was a risk factor for NAA in the 50–59 and ≥ 60 years groups (AOR [95% CI]: 1.42 [1.04–1.91] and 2.33 [1.34–4.09], respectively), but not in the 30–39 and 40–49 years groups. In the curve of age‐specific prevalence of NAA, the gap of the prevalence between the family history and non‐family history groups began to widen after the mid‐50s. In cases of ACRN, a family history of CRC was not a risk factor in the entire age group (AOR 1.16, 95% CI 0.75–1.70). In the curve of age‐specific prevalence of ACRN, however, the gap of the prevalence between the family history and non‐family history groups began to widen after the early 60s. Conclusion Although a family history of CRC is a risk factor for NAA, it may affect NAA development from the mid‐50s and ACRN development from the early 60s.

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Lower Relative Contribution of Positive Family History to Colorectal Cancer Risk with Increasing Age: A Systematic Review and Meta-Analysis of 9.28 Million Individuals

Cited by 44 publications

References 80 publications

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

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

Family history of cancer and subsequent risk of cancer: A large‐scale population‐based prospective study in Japan

Impact of family history of colorectal cancer on age‐specific prevalence of colorectal neoplasia

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