All Relatives of Patients With Colorectal Cancer May Be at Increased Risk Regardless of Age at Diagnosis of Index Patient

All Relatives of Patients With Colorectal Cancer May Be at Increased Risk Regardless of Age at Diagnosis of Index Patient

By The ASCO Post
Key Points:

  • Researchers identified a more than twofold increase in risk of colorectal cancer among young first-degree relatives (under 50 years of age) of individuals diagnosed with colorectal cancer at advanced ages (60–80 years).
  • Increased risk was observed in all relatives regardless of age of the family member’s cancer diagnosis, although the risk was greatest for young relatives (under 50 years) of individuals who were diagnosed with colorectal cancer before 40 years of age.
  • These findings support the current screening guidelines for patients with a family history of colorectal cancer.

All relatives of individuals with colorectal cancer are at increased risk for this cancer, regardless of the age of diagnosis of the index patient in the family, according to a study published by Samadder et al in Clinical Gastroenterology and Hepatology. These findings may impact future guidelines regarding colorectal cancer screening.

“Most surprising, we identified a more than twofold increase in risk of colorectal cancer among young first-degree relatives (under 50 years of age) of individuals diagnosed with colorectal cancer at advanced ages (60–80 years),” said N. Jewel Samadder, MSc, MD, from Huntsman Cancer Institute at the University of Utah. “This risk is not currently appreciated. Increased awareness of this risk may serve as incentive to increase screening intensity for all patients with a first-degree family history of colorectal cancer.”

Study Details

The researchers conducted a population-based, case-control study in Utah identifying 18,208 index patients from the Utah Cancer Registry diagnosed with colorectal cancer between 1980 and 2010; age- and sex-matched cancer-free individuals were selected to form the comparison group.

Increased risk was observed in all relatives regardless of age of the family member’s cancer diagnosis, although the risk was greatest for young relatives (under 50 years) of individuals who were diagnosed with colorectal cancer before 40 years of age. However, familial risk was increased in first-degree relatives, even when the index patient was diagnosed with cancer at an advanced age (older than 80 years).

These findings support the current screening guidelines for patients with a family history of colorectal cancer, primarily more aggressive screening for first-degree relatives of persons with colorectal cancer at an age younger than 60 years. However, because a colorectal cancer diagnosis, even in an older patient, can be a predictor of higher risk of this cancer in their relatives, relatives might benefit from knowing this moderate risk, thus avoiding known modifiable risk factors and considering preventive measures.

Dr. Samadder is the corresponding author of the Clinical Gastroenterology and Hepatology article.

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