Risk factors for metachronous colorectal cancer following a primary colorectal cancer: A prospective cohort study.
Individuals diagnosed with colorectal cancer (CRC) are at risk of developing a metachronous CRC. We examined the associations between personal, tumour-related and lifestyle risk factors, and risk of metachronous CRC. A total of 7,863 participants with incident colon or rectal cancer who were recruited in the USA, Canada and Australia to the Colon Cancer Family Registry during 1997-2012, except those identified as high-risk, for example, Lynch syndrome, were followed up approximately every 5 years. We estimated the risk of metachronous CRC, defined as the first new primary CRC following an interval of at least one year after the initial CRC diagnosis. Observation time started at the age at diagnosis of the initial CRC and ended at the age at diagnosis of the metachronous CRC, last contact or death whichever occurred earliest, or were censored at the age at diagnosis of any metachronous colorectal adenoma. Cox regression was used to derive hazard ratios (HRs) and 95% confidence intervals (CIs). During a mean follow-up of 6.6 years, 142 (1.81%) metachronous CRCs were diagnosed (mean age at diagnosis 59.8; incidence 2.7/1,000 person-years). An increased risk of metachronous CRC was associated with the presence of a synchronous CRC (HR = 2.73; 95% CI: 1.30-5.72) and the location of cancer in the proximal colon at initial diagnosis (compared with distal colon or rectum, HR = 4.16; 95% CI: 2.80-6.18). The presence of a synchronous CRC and the location of the initial CRC might be useful for deciding the intensity of surveillance colonoscopy for individuals diagnosed with CRC.
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.|Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia.
Harindra
H
Jayasekara
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
Jeanette C
JC
Reece
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.|Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, VIC, Australia.
Daniel D
DD
Buchanan
Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, VIC, Australia.|School of Medicine, University of Queensland, Herston, QLD, Australia.
Christophe
C
Rosty
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
S Ghazaleh
SG
Dashti
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
Driss
D
Ait Ouakrim
Department of Medicine, Royal Melbourne Hospital, the University of Melbourne, Parkville, VIC, Australia.|Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, VIC, Australia.
Ingrid M
IM
Winship
Department of Medicine, Royal Melbourne Hospital, the University of Melbourne, Parkville, VIC, Australia.|Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, VIC, Australia.|Colorectal Medicine and Genetics, Royal Melbourne Hospital, Parkville, VIC, Australia.
Finlay A
FA
Macrae
Department of Medicine, Royal Melbourne Hospital, the University of Melbourne, Parkville, VIC, Australia.|Cancer Genomics and Predictive Medicine, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
Alex
A
Boussioutas
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.|Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia.
Graham G
GG
Giles
Department of Medicine, University of Colorado School of Medicine, Denver, CO.
Dennis J
DJ
Ahnen
Department of Epidemiology, University of Colorado School of Public Health, Denver, CO.
Jan
J
Lowery
Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA.
Graham
G
Casey
Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, CA.
Robert W
RW
Haile
Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
Steven
S
Gallinger
University of Hawaii Cancer Center, Honolulu, HI.
Loic
L
Le Marchand
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA.|School of Public Health, University of Washington, Seattle, WA.
Polly A
PA
Newcomb
Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ.
Noralane M
NM
Lindor
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
John L
JL
Hopper
New Zealand Familial Gastrointestinal Cancer Service, Auckland, New Zealand.
Susan
S
Parry
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
Mark A
MA
Jenkins
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
Aung Ko
AK
Win
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors
colorectal cancer; metachronous; risk factors