title: How well does family history predict who will get colorectal cancer? Implications for cancer screening and counseling.
abstract: OBJECTIVE
  Using a large, retrospective cohort from the Utah Population Database, we assess how well family history predicts who will acquire colorectal cancer during a 20-year period.
  
  
  METHODS
  Individuals were selected between ages 35 and 80 with no prior record of colorectal cancer diagnosis, as of the year 1985. Numbers of colorectal cancer-affected relatives and diagnosis ages were collected. Familial relative risk and absolute risk estimates were calculated. Colorectal cancer diagnoses in the cohort were counted between years 1986 and 2005. Cox regression and Harrell's C were used to measure the discriminatory power of resulting models.
  
  
  RESULTS
  A total of 431,153 individuals were included with 5,334 colorectal cancer diagnoses. Familial relative risk ranged from 0.83 to 12.39 and 20-year absolute risk from 0.002 to 0.21. With familial relative risk as the only predictor, Harrell's C = 0.53 and with age only, Harrell's C = 0.66. Familial relative risk combined with age produced a Harrell's C = 0.67.
  
  
  CONCLUSIONS
  Family history by itself is not a strong predictor of exactly who will acquire colorectal cancer within 20 years. However, stratification of risk using absolute risk probabilities may be more helpful in focusing screening on individuals who are more likely to develop the disease.
authors.affiliation: Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah 84112-5750, USA. d.p.taylor@utah.edu
authors.forename: David P
authors.initials: DP
authors.lastname: Taylor
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Stoddard
authors.forename: Randall W
authors.initials: RW
authors.lastname: Burt
authors.forename: Marc S
authors.initials: MS
authors.lastname: Williams
authors.forename: Joyce A
authors.initials: JA
authors.lastname: Mitchell
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Haug
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Cannon-Albright
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000235:genetics* / Q000401:mortality; D055088:Early Detection of Cancer; D005817:Genetic Counseling; D006801:Humans; D008875:Middle Aged; D015233:Models, Statistical; D012189:Retrospective Studies; D018570:Risk Assessment; D014589:Utah / Q000453:epidemiology