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. 2018 May;7(5):2192-2199.
doi: 10.1002/cam4.1470. Epub 2018 Mar 26.

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

Dawn Q Chong  1 , Barbara L Banbury  2 , Amanda I Phipps  2   3 , Xinwei Hua  2 , Jonathan Kocarnik  2   4 , Ulrike Peters  2 , Sonja I Berndt  5 , Wen-Yi Huang  6 , John D Potter  2   3   7 , Martha L Slattery  8 , Emily White  2   3 , Peter T Campbell  9 , Tabitha Harrison  2   3 , Polly A Newcomb  2   3 , Andrew T Chan  10   11   12
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Association of family history and survival in patients with colorectal cancer: a pooled analysis of eight epidemiologic studies

Dawn Q Chong et al. Cancer Med. 2018 May.

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.

Keywords: Colorectal cancer; family history; first-degree relative; mortality; survival.

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