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

作者：Chong Dawn Q; Banbury Barbara L; Phipps Amanda I; Hua Xinwei; Kocarnik Jonathan; Peters Ulrike; Berndt Sonja I; Huang Wen Yi; Potter John D; Slattery Martha L; White Emily; Campbell Peter T; Harrison Tabitha; Newcomb Polly A; Chan Andrew T^*

来源：Cancer Medicine, 2018, 7(5): 2192-2199.

DOI：10.1002/cam4.1470

• Colorectal cancer
• family history
• first-degree relative
• mortality
• survival

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 P-trend > 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.

• 出版日期2018-5