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Association of family history and survival in patients with colorectal cancer: a pooled analysis of eight epidemiologic studies.

About this Publication
Title
Association of family history and survival in patients with colorectal cancer: a pooled analysis of eight epidemiologic studies.
Pubmed ID
29582567 (View this publication on the PubMed website)
Digital Object Identifier
Publication
Cancer Med. 2018 May; Volume 7 (Issue 5): Pages 2192-2199
Authors
Chong DQ, Banbury BL, Phipps AI, Hua X, Kocarnik J, Peters U, Berndt SI, Huang WY, Potter JD, Slattery ML, White E, Campbell PT, Harrison T, Newcomb PA, Chan AT
Affiliations
  • Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
  • Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
  • Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
  • Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
  • Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah.
  • Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
  • Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Abstract

A family history of colorectal cancer (CRC) in first-degree relatives (FDRs) increases the risk of CRC. However, the influence of family history on survival among CRC patients remains unclear. We conducted a pooled analysis of survival in 5010 incident CRC cases. Cox proportional hazards models were used to estimate the association of family history with overall survival (OS) and CRC-specific survival (CSS). We also assessed the impact of the number of affected FDRs and age at CRC diagnosis in the affected FDRs on survival. Among CRC cases, 819 (16%) patients reported a family history of CRC. There were 1580 total deaths over a median follow-up of 4.6 years, of which 1046 (66%) deaths were due to CRC. Having a family history of CRC was not associated with OS [hazard ratio (HR), 1.03; 95% confidence interval (CI), 0.89-1.19] or CSS (HR, 1.13; 95% CI, 0.95-1.36)]. There were no associations between the number of affected relatives or age at CRC diagnosis of the affected relative with survival (all Ptrend  > 0.05). However, a family history of CRC did confer worse CSS in patients diagnosed with distal colon cancer (HR, 1.45, 95% CI, 1.03-2.04). A family history of CRC was generally not associated with survival after CRC diagnosis. However, having a family history of CRC was associated with worse CRC prognosis in individuals with distal colon cancer, suggesting a possible genetic predisposition with distinct pathogenic mechanism that may lead to worse survival in this group.

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