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Familial risk of cancer shortly after diagnosis of the first familial tumor.
J Natl Cancer Inst. 2005 Nov 02; 97(21):1575-9.JNCI

Abstract

BACKGROUND

The diagnosis of the first cancer in a family may lead to the medical examination of the patient's relatives and the subsequent identification of additional familial cancers. If detection bias is present, familial risks could be overestimated soon after first diagnosis.

METHODS

We followed 1,677,722 offspring/siblings of 846,448 probands from the year of diagnosis of the first familial tumor to the diagnosis of first cancer, death, emigration, or December 31, 2002, using the Swedish Family Cancer Database. The risks of cancer among the offspring and siblings of patients with melanoma and cancers of the breast, prostate, colorectum, cervix, and lung were compared with those in the general population. Relative risks (RRs) were determined using Poisson regression, according to the time after first diagnosis. All statistical tests were two-sided.

RESULTS

Daughters of women with breast cancer had a statistically significantly higher relative risk of in situ breast cancer during the year of the mother's diagnosis than they did 5 or more years later (RR = 4.78, 95% confidence interval [CI] = 2.16 to 10.6, 26.6 cases per 100,000, versus RR = 1.97, 95% CI = 1.65 to 2.37, 27.2 cases per 100,000; P = .033). Daughters diagnosed the same year as their mothers were younger and were diagnosed earlier in the calendar year than daughters of women diagnosed 5 or more years after their mothers. Similarly, the risk of invasive melanoma among the offspring of individuals with invasive melanoma was higher during the year of the parent's diagnosis than it was 5 or more years afterward (RR = 8.27, 95% CI = 3.82 to 17.9, 57.0 cases per 100,000, versus RR = 3.18, 95% CI = 2.55 to 3.97, 37.6 cases per 100,000; P = .019). Sibling risks of in situ breast cancer, in situ cervical cancer, and invasive prostate cancer also decreased with time after diagnosis of the first familial tumor.

CONCLUSIONS

Increased surveillance may result in the earlier detection of asymptomatic familial cancers, i.e., in detection bias. The possibility of overestimated familial risks of cancer shortly after diagnosis of the first familial tumor should be considered before a patient's clinical and genetic counseling is implemented.

Authors+Show Affiliations

Division of Molecular Genetic Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany. J.Lorenzo@dkfz.deNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16264177

Citation

Bermejo, J Lorenzo, and Kari Hemminki. "Familial Risk of Cancer Shortly After Diagnosis of the First Familial Tumor." Journal of the National Cancer Institute, vol. 97, no. 21, 2005, pp. 1575-9.
Bermejo JL, Hemminki K. Familial risk of cancer shortly after diagnosis of the first familial tumor. J Natl Cancer Inst. 2005;97(21):1575-9.
Bermejo, J. L., & Hemminki, K. (2005). Familial risk of cancer shortly after diagnosis of the first familial tumor. Journal of the National Cancer Institute, 97(21), 1575-9.
Bermejo JL, Hemminki K. Familial Risk of Cancer Shortly After Diagnosis of the First Familial Tumor. J Natl Cancer Inst. 2005 Nov 2;97(21):1575-9. PubMed PMID: 16264177.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Familial risk of cancer shortly after diagnosis of the first familial tumor. AU - Bermejo,J Lorenzo, AU - Hemminki,Kari, PY - 2005/11/3/pubmed PY - 2005/12/13/medline PY - 2005/11/3/entrez SP - 1575 EP - 9 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 97 IS - 21 N2 - BACKGROUND: The diagnosis of the first cancer in a family may lead to the medical examination of the patient's relatives and the subsequent identification of additional familial cancers. If detection bias is present, familial risks could be overestimated soon after first diagnosis. METHODS: We followed 1,677,722 offspring/siblings of 846,448 probands from the year of diagnosis of the first familial tumor to the diagnosis of first cancer, death, emigration, or December 31, 2002, using the Swedish Family Cancer Database. The risks of cancer among the offspring and siblings of patients with melanoma and cancers of the breast, prostate, colorectum, cervix, and lung were compared with those in the general population. Relative risks (RRs) were determined using Poisson regression, according to the time after first diagnosis. All statistical tests were two-sided. RESULTS: Daughters of women with breast cancer had a statistically significantly higher relative risk of in situ breast cancer during the year of the mother's diagnosis than they did 5 or more years later (RR = 4.78, 95% confidence interval [CI] = 2.16 to 10.6, 26.6 cases per 100,000, versus RR = 1.97, 95% CI = 1.65 to 2.37, 27.2 cases per 100,000; P = .033). Daughters diagnosed the same year as their mothers were younger and were diagnosed earlier in the calendar year than daughters of women diagnosed 5 or more years after their mothers. Similarly, the risk of invasive melanoma among the offspring of individuals with invasive melanoma was higher during the year of the parent's diagnosis than it was 5 or more years afterward (RR = 8.27, 95% CI = 3.82 to 17.9, 57.0 cases per 100,000, versus RR = 3.18, 95% CI = 2.55 to 3.97, 37.6 cases per 100,000; P = .019). Sibling risks of in situ breast cancer, in situ cervical cancer, and invasive prostate cancer also decreased with time after diagnosis of the first familial tumor. CONCLUSIONS: Increased surveillance may result in the earlier detection of asymptomatic familial cancers, i.e., in detection bias. The possibility of overestimated familial risks of cancer shortly after diagnosis of the first familial tumor should be considered before a patient's clinical and genetic counseling is implemented. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/16264177/Familial_risk_of_cancer_shortly_after_diagnosis_of_the_first_familial_tumor_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/dji338 DB - PRIME DP - Unbound Medicine ER -