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Journal of Cancer Prevention

Original Article

J Cancer Prev 2019; 24(1): 1-10

Published online March 30, 2019

https://doi.org/10.15430/JCP.2019.24.1.1

© Korean Society of Cancer Prevention

Association of Family History With Cancer Recurrence, Survival, and the Incidence of Colorectal Adenoma in Patients With Colorectal Cancer

Yehyun Park1, Soo Jung Park1, Jae Hee Cheon1, Won Ho Kim1, Tae Il Kim1,2,3

1Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 2Cancer Prevention Center, Yonsei Cancer Center, 3Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea

Correspondence to :
Tae Il Kim
E-mail: taeilkim@yuhs.ac, ORCID: Tae Il Kim, https://orcid.org/0000-0003-4807-890X

Received: March 20, 2019; Accepted: March 21, 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

The influence of family history (FH) on cancer recurrence and survival among patients with established colorectal cancer (CRC) remains uncertain. This study aimed to evaluate the association of FH with cancer recurrence, survival, and the incidence of colorectal adenomas in patients with CRC.

Methods

Consecutive patients with stage III CRC diagnosed between 2004 and 2009 and followed-up in Severance Hospital were retrospectively enrolled and followed until December 2014. Overall survival (OS) and disease-free survival (DFS) according to FH of CRC or colorectal neoplasm were evaluated using Cox proportional hazards regression and Kaplan–Meier curve.

Results

Among analyzed 979 patients, 69 (7.0%) was identified as having a FH of CRC in a first-degree relative. During a median follow-up of 9.6 years, mortality occurred in 14 of 69 patients (20.3%) with a FH of CRC and 348 of 910 patients (38.2%) without a FH. Compared with patients without a FH, a first-degree FH of CRC, first or second-degree FH of CRC, and first-degree FH of colorectal neoplasm (CRC or polyps) were associated with a significant reduction in the risk of overall mortality, with adjusted hazard ratios (HRs) of 0.52 (95% CI, 0.29–0.92), 0.51 (95% CI, 0.30–0.88), and 0.48 (95% CI, 0.28–0.82), respectively. However, DFS improvement was significant only when the definition of FH was FH of colorectal neoplasm (adjusted HR 0.57; 95% CI, 0.36–0.89). The incidence of adenoma and advanced adenoma was not different according to the FH.

Conclusions

Among patients with stage III CRC receiving curative surgery, a FH of colorectal neoplasm was associated with a reduction in cancer recurrence and mortality. The larger scaled studies are needed.

Keywords: Colorectal cancer, Family, Survival, Adenoma

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