title: Differences in survival for patients with familial and sporadic cancer.
abstract: Family history of cancer is a well-known risk factor but the role of family history in survival is less clear. The aim of this study was to investigate the association between family history and cancer survival for the common cancers in Sweden. Using the Swedish population-based registers, patients diagnosed with the most common cancers were followed for cancer-specific death during 1991-2010. We used multivariate proportional hazards (Cox) regression models to contrast the survival of patients with a family history of cancer (individuals whose parent or sibling had a concordant cancer) to the survival of patients without a family history. Family history of cancer had a modest protective effect on survival for breast cancer (hazard ratio (HR) = 0.88, 95% confidence interval (95% CI) = 0.81 to 0.96) and prostate cancer (HR = 0.82, 95% CI = 0.75 to 0.90). In contrast, family history of cancer was associated with worse survival for nervous system cancers (HR = 1.24, 95% CI = 1.05 to 1.47) and ovarian cancer (HR = 1.20, 95% CI = 1.01 to 1.43). Furthermore, the poorer survival for ovarian cancer was consistent with a higher FIGO stage and a greater proportion of more aggressive tumors of the serous type. The better survival for patients with a family history of breast and prostate cancer may be due to medical surveillance of family members. The poor survival for ovarian cancer patients with an affected mother or sister is multifactorial, suggesting that these cancers are more aggressive than their sporadic counterparts.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.|Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea.
authors.forename: Myeongjee
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Reilly
authors.affiliation: Department of Biosciences and Nutrition, Karolinska Institutet and University Hospital, Stockholm, Sweden.|Department of Surgery, University of California at San Francisco (UCSF), San Francisco, C, A.
authors.forename: Linda Sofie
authors.initials: LS
authors.lastname: Lindström
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kamila
authors.initials: K
authors.lastname: Czene
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009035:Mothers; D009369:Neoplasms / Q000401:mortality*; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D035781:Siblings; D013548:Sweden
keywords: common cancers; family history; histology; population-based; survival