Urinary tract cancer and hereditary nonpolyposis colorectal cancer: risks and screening options.
OBJECTIVE
We investigate the risk of the different types of urinary tract cancer in hereditary nonpolyposis colorectal cancer families and review screening options.


METHODS
We retrospectively calculated the relative and cumulative risks of developing urinary tract cancer by comparing tumor occurrence in patients and their first degree relatives in the Dutch hereditary nonpolyposis colorectal cancer registry with those in the general Dutch population. A person-year analysis was used, including data on 1,321 individuals from 50 hereditary nonpolyposis colorectal cancer families.


RESULTS
The relative risk of developing transitional cell cancer of the renal pelvis or ureter was 14.04 (95% confidence interval 6.69 to 29.45, p <0.05) and the cumulative risk was 2.6%. The risks of renal (excluding renal pelvis) and bladder cancers were not significantly increased. Urinary tract cancer was diagnosed at a relatively young age and many women were affected. Some familial clustering was observed.


CONCLUSIONS
Our findings indicate that hereditary nonpolyposis colorectal cancer is associated with an increased risk of transitional cell cancer of the upper urinary tract. The cumulative risk is relatively low, although a subset of hereditary nonpolyposis colorectal cancer families may be exposed to a much higher risk. As yet nothing is known of the clinical impact of screening for urinary tract cancer in cases of hereditary nonpolyposis colorectal cancer. In a research setting screening by excretory urography of hereditary nonpolyposis colorectal cancer families with a strong history of upper urinary tract cancer should be considered.
Department of Medical Genetics, University of Groningen, The Netherlands.
R H
RH
Sijmons
L A
LA
Kiemeney
J A
JA
Witjes
H F
HF
Vasen
D000367:Age Factors; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology; D016000:Cluster Analysis; D003110:Colonic Neoplasms / Q000235:genetics* / Q000517:prevention & control; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000453:epidemiology; D007682:Kidney Pelvis / Q000473:pathology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000235:genetics* / Q000517:prevention & control; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014516:Ureteral Neoplasms / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology; D014567:Urography; D014571:Urologic Neoplasms / Q000453:epidemiology* / Q000517:prevention & control