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27-03-2013 | Gastroenterology | Article

Family history linked to colorectal cancer survival


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medwireNews: A family history of colorectal cancer (CRC) is associated with an increased, rather than decreased, chance for survival after diagnosis, UK researchers have found.

Indeed, having a first-degree relative with bowel cancer was associated with an 11% decrease in the risk for death from CRC when compared with having no parent, sibling, or child with the disease (hazard ratio=0.89).

"The basis of a survival advantage associated with familial CRC is unclear," explain Eva Morris (Leeds Institute of Molecular Medicine) and co-workers, noting that there was no evidence that heightened awareness, early presentation, and thus early treatment were involved.

They did, however, find that patients with familial CRC were more likely to have right-sided tumors, which are biologically different from other tumor types and may respond better to treatment.

Family history is known to influence the risk for developing CRC, with relatives of CRC patients having around a two- to threefold higher risk for developing the disease themselves. Much less is known, however, about the influence of family history on patient survival.

The researchers matched genetic data on 10,782 CRC patients from the UK National Study of Colorectal Cancer Genetics (NSCCG) database to information on patients in the UK National Cancer Data Registry (NCDR). For logistical reasons this only included patients diagnosed in England between 1990 and 2008.

In total, 1697 (15.7%) individuals with CRC reported that they had a parent, sibling, or child with CRC. The median age of those with and without a family history of CRC was 60 years.

There were no significant differences between the patients with and without a family history of CRC in Duke's stage, presence of multiple cancers, comorbidity, mode of presentation to hospital, or surgical management.

"The overall 5-year survival for familial CRC was significantly better than those with sporadic disease," Morris and team observe.

"The survival advantage was correlated to the number of affected family members," they add, with the best survival seen in patients with two or more family members with the disease.

"Studies like this, which link genetic data to detailed patient information, may help us to develop a more personalized approach to treating cancer in the future," Julie Sharp (Cancer Research UK, London) said in a press statement.

"Now we need to find out more about what is causing this difference," she added, noting that the study was "another important step forward in our understanding of bowel cancer."

By Sara Freeman, medwireNews Reporter

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