Risk of colorectal cancer by family history of both colorectal carcinomas and colorectal polyps: a nationwide cohort study.

IF 24.9 1区 医学 Q1 ONCOLOGY
Yuqing Hu, Elham Kharazmi, Qunfeng Liang, Hermann Brenner, Jan Sundquist, Kristina Sundquist, Mahdi Fallah
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引用次数: 0

Abstract

Background: The increased risk of colorectal cancer (CRC) associated with family history of both colorectal in situ or invasive carcinomas (Stage 0 to IV) and colorectal polyps is attributed solely to family history of CRC, resulting in an underestimation of the actual risk. We aimed to assess the association between overall and early-onset CRC (EOCRC) risk and family history of both colorectal carcinomas and polyps.

Methods: We conducted a nationwide cohort study leveraging Swedish family-cancer datasets with follow-up from 1964 to 2018. Standardized incidence ratios (SIRs) were calculated to estimate the risk of CRC and EOCRC among individuals with a family history of both colorectal polyps and carcinomas.

Results: We followed up 13,432,205 individuals for up to 54 years. The risk of overall CRC was 2.2 times increased in individuals with 1 first-degree relative (FDR) with one-time polyp diagnosis and an additional FDR with carcinoma (95% CI = 2.1-2.3; EOCRC SIR = 2.9 [95% CI = 2.4-3.4]). The risk was significantly higher in individuals with 1 FDR with repeated polyp diagnoses (≥2 times) and an additional FDR with carcinoma (overall SIR = 2.9 [95% CI = 2.7-3.1]; EOCRC SIR = 5.4 [95% CI = 3.9-6.4]). A similar risk was observed in individuals with ≥2 FDRs with one-time polyp diagnosis and an additional FDR with carcinoma (overall SIR = 2.9 [95% CI = 2.4-3.4]; EOCRC SIR = 5.3 [95% CI = 3.0-8.6]). Individuals with ≥2 FDRs with repeated polyp diagnoses and an additional FDR with carcinoma had a 5.0-fold overall risk (95% CI = 4.3-5.7) and a 13.8-fold EOCRC risk (95% CI = 9.7-20.1). Younger age at polyp/carcinoma diagnoses, and more relatives with polyps and carcinomas were associated with higher CRC risk.

Conclusions: Individuals with a family history of both colorectal polyps and carcinomas are at significantly increased risk of CRC, especially EOCRC. The risk increased with frequent polyp diagnoses, younger age at first polyp/carcinoma diagnoses, and the number of relatives with polyps/carcinomas. This study highlights the importance of considering both colorectal polyps and carcinomas in family history when assessing CRC risk. These findings could supplement current screening guidelines.

结直肠癌和结直肠息肉家族史对结直肠癌风险的影响:一项全国性队列研究
背景:与结直肠癌原位癌或侵袭性癌(0期至IV期)和结直肠息肉家族史相关的结直肠癌(CRC)风险增加仅归因于结直肠癌家族史,导致实际风险被低估。我们的目的是评估总体和早发性CRC (EOCRC)风险与结直肠癌和息肉家族史之间的关系。方法:我们利用瑞典家庭癌症数据集进行了一项全国性队列研究,随访时间为1964年至2018年。计算标准化发病率(SIRs),以估计有结直肠息肉和癌家族史的个体发生CRC和EOCRC的风险。结果:我们对13432205人进行了长达54年的随访。有1个一级亲属(FDR)一次性诊断为息肉,另一个一级亲属诊断为癌的患者发生总结直肠癌的风险增加2.2倍(95% CI = 2.1-2.3; EOCRC SIR = 2.9 [95% CI = 2.4-3.4])。有1次FDR并反复诊断为息肉(≥2次)和另外1次FDR并诊断为癌的患者的风险明显更高(总SIR = 2.9 [95% CI = 2.7-3.1]; EOCRC SIR = 5.4 [95% CI = 3.9-6.4])。在FDR≥2次且诊断为一次性息肉和另外一次FDR为癌的个体中观察到类似的风险(总SIR = 2.9 [95% CI = 2.4-3.4]; EOCRC SIR = 5.3 [95% CI = 3.0-8.6])。FDR≥2例并反复诊断为息肉和FDR合并癌的个体总风险为5.0倍(95% CI = 4.3-5.7), EOCRC风险为13.8倍(95% CI = 9.7-20.1)。息肉/癌诊断年龄越小,息肉和癌亲属越多,结直肠癌风险越高。结论:有结直肠息肉和癌家族史的个体发生结直肠癌的风险显著增加,尤其是EOCRC。息肉的频繁诊断、首次诊断为息肉/癌的年龄越小,以及患有息肉/癌的亲属数量越多,风险就越高。这项研究强调了在评估结直肠癌风险时考虑家族病史中结直肠息肉和癌的重要性。这些发现可以补充目前的筛查指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cancer Communications
Cancer Communications Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
25.50
自引率
4.30%
发文量
153
审稿时长
4 weeks
期刊介绍: Cancer Communications is an open access, peer-reviewed online journal that encompasses basic, clinical, and translational cancer research. The journal welcomes submissions concerning clinical trials, epidemiology, molecular and cellular biology, and genetics.
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