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Family history and survival after colorectal cancer diagnosis
Version of Record online: 24 JAN 2008
Copyright © 2008 American Cancer Society
Volume 112, Issue 6, pages 1222–1229, 15 March 2008
How to Cite
Bass, A. J., Meyerhardt, J. A., Chan, J. A., Giovannucci, E. L. and Fuchs, C. S. (2008), Family history and survival after colorectal cancer diagnosis. Cancer, 112: 1222–1229. doi: 10.1002/cncr.23294
- Issue online: 3 MAR 2008
- Version of Record online: 24 JAN 2008
- Manuscript Accepted: 2 OCT 2007
- Manuscript Revised: 27 SEP 2007
- Manuscript Received: 20 JUN 2007
- National Cancer Institute. Grant Number: P01CA087969
- colorectal cancer;
- family history;
- cohort study;
A history of colorectal cancer in a first-degree relative is a recognized risk factor for developing this malignancy. The influence of a family history of colorectal cancer on survival after a diagnosis of colorectal cancer was examined in a large cohort of women.
We analyzed data from 1001 women diagnosed with colorectal cancer while participating in a prospective cohort study. Data on family history were obtained before cancer diagnosis. We computed Cox proportional hazards for cancer-specific and overall mortality according to a family history of colorectal cancer, adjusting for other predictors for survival.
Before diagnosis, 16% of colorectal patients reported a history of colorectal cancer in a first-degree relative. Patients with a history of colorectal cancer in 1 or more first-degree relatives experienced an adjusted hazard ratio (HR) for overall mortality of 1.32 (95% confidence interval [CI], 1.01–1.72) and colorectal cancer-specific mortality of 1.38 (95% CI, 1.02–1.86) when compared with those without a family history. Moreover, patients with 2 or more affected relatives had an HR for overall mortality of 2.07 (95% CI, 1.14–3.76) and cancer-specific mortality of 2.19 (95% CI, 1.10–4.38). The significant deleterious effect of family history was limited to patients with advanced disease at presentation and cancers originating in the colon.
Among women with colorectal cancer, a history of colorectal cancer in a first-degree relative was associated with a significant decrease in survival. Additional study is needed to validate these findings and determine whether specific germline polymorphisms correlate with clinical outcomes. Cancer 2008. © 2008 American Cancer Society.