The impact of family history on the outcome of patients with colorectal cancer in a veterans' hospital.
OBJECTIVE
The purpose of the study was to investigate the impact of a family history (FH) of colorectal cancer (CRC) in first-degree relatives on the outcome of patients with CRC in a veterans' hospital in Taiwan.


METHODS
Patients (N = 3,383) with colorectal adenocarcinoma were studied; pedigrees were collected prospectively. Associations between FH and clinicopathologic variables were analyzed using linear-by-linear association. Survival was examined with Kaplan-Meier curves and the log-rank test.


RESULTS
Two hundred ninety-seven patients (8.78%) had a first-degree relative with CRC. The average age of onset of CRC was 68.3 years in patients without a FH. This was significantly higher than the age of onset in patients with a FH (66.4 years--one first-degree relative with CRC; 48.8 years--two or more first-degree relatives, P < 0.001). Patients with more affected family members had a higher incidence of right-sided tumor (P = 0.004), metachronous cancer (P = 0.034), and less-advanced disease (P = 0.044). The 5-year overall survival was 83% for patients with two or more first-degree relatives with CRC, 57% for those with one first-degree relative, and 55% for those without a FH (P = 0.001). The 5-year DFS was 91% for patients with two or more first-degree relatives, 66% for those with one first-degree relative, and 64% for those without a FH of CRC (P = 0.002). In the multivariate analysis, TNM stage played the most independent prognostic factor, followed by FH (P < 0.001, hazard ratio = 1.52; 95% confidence interval, 1.24-1.85).


CONCLUSIONS
CRC patients with a family history of CRC had better survival than did those without a family history of CRC.
Kao
Ping-Sheng
PS
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, No 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan.
Lin
Jen-Kou
JK
Wang
Huann-Sheng
HS
Yang
Shung-Haur
SH
Jiang
Jeng-Kai
JK
Chen
Wei-Shone
WS
Lin
Tzu-Chen
TC
Li
Anna Fen-Yau
AF
Liang
Wen-Yi
WY
Chang
Shih-Ching
SC
D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D018572:Disease-Free Survival; D005192:Family Health; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D013624:Taiwan; D016896:Treatment Outcome