Family history of colorectal adenomatous polyps and increased risk for colorectal cancer
Family history of colorectal adenomatous polyps and increased risk for colorectal cancer
复制标题
DOI：
10.7326/0003-4819-128-11-199806010-00006
复制
发表时间：
1998-06-01
影响因子：
39.2
通讯作者：
Waye, JD
中科院分区：
文献类型：
--
作者：
Ahsan, H;Neugut, AI;Waye, JD
背景：结直肠癌患者家庭成员患结直肠癌的风险已明确，但结直肠腺瘤患者家庭成员患结直肠癌的风险尚未明确。目的：比较腺瘤患者的一级亲属与无腺瘤对照组的一级亲属患结直肠癌的风险。设计：重建队列研究。背景：纽约市三所大学的结肠镜检查诊所。患者：1554 名244 名新诊断腺瘤患者的一级亲属和 362 名内镜检查正常对照的 2173 名一级亲属。测量：采用结构化访谈来获取家族史。根据Cox比例风险回归模型估计调整后的相对风险（RR）。结果：与对照的一级亲属相比，新诊断腺瘤患者的一级亲属患结直肠癌的风险升高（RR，1.74 [95% CI，1.24至2.45]）。对于父母（RR，1.58 [CI，1.07 至 2.34]）和兄弟姐妹（RR，1.58 [CI，0.81 至 3.08]），这种风险增加是相同的。腺瘤患者的一级亲属患其他癌症的风险并未升高。随着先证者诊断腺瘤年龄的降低，家庭成员患结直肠癌的风险增加。诊断腺瘤时年龄为 50 岁或以下的患者的一级亲属中，其风险比诊断为腺瘤时年龄超过 60 岁的患者的一级亲属高四倍以上。结论：新诊断腺瘤患者的一级亲属，尤其是 50 岁或以下的患者在诊断时，患有结直肠癌的风险增加，应接受类似于对结直肠癌患者亲属推荐的筛查。
Background: The risk for colorectal cancer among family members of patients with colorectal cancer is well established, but the risk among family members of patients with colorectal adenomas is less well established.Objective: To examine the risk for colorectal cancer among first-degree relatives of patients with adenoma compared with that among first-degree relatives of controls without adenoma.Design: Reconstructed cohort study.Setting: Three university-based colonoscopy practices in New York City.Patients: 1554 first-degree relatives of 244 patients with newly diagnosed adenomas and 2173 first-degree relatives of 362 endoscopically normal controls.Measurements: Structured interviews were used to obtain family history. Adjusted relative risks (RR) were estimated from Cox proportional hazards regression models.Results: The risk for colorectal cancer was elevated (RR, 1.74 [95% CI, 1.24 to 2.45]) among first-degree relatives of patients with newly diagnosed adenomas compared with the risk among first-degree relatives of controls. This increased risk was the same for parents (RR, 1.58 [CI, 1.07 to 2.34]) and siblings (RR, 1.58 [CI, 0.81 to 3.08]). First-degree relatives of patients with adenomas did not have elevated risk for other cancers. The risk for colorectal cancer among family members increased with decreasing age at diagnosis of adenoma in probands. Among first-degree relatives of patients who were 50 years of age or younger when the adenoma was diagnosed, the risk was more than four times greater (RR, 4.36 [CI, 2.24 to 8.51]) than that among first-degree relatives of patients who were older than 60 years of age when the adenoma was diagnosed.Conclusions: First-degree relatives of patients with newly diagnosed adenomas, particularly of patients who are 50 years of age or younger at diagnosis, are at increased risk for colorectal cancer and should undergo screening similar to that recommended for relatives of patients with colorectal cancer.