Family history ofcolorectal tumoursand implications fortheadenoma-carcinoma sequence:a casecontrol study

Familyhistory ofcolorectal cancer isarisk factor forsporadic colorectal cancer, butit isnotknownwhichstepoftheadenomacarcinoma pathway itinfluences. Thiscase control studyinvestigated therelation betweenfamilyhistory ofcancerand colorectal adenomasandcancers. Family history ofcolorectal cancer(FHCRC)was asfrequent insmall( 0.10) forsmalladenomasand2.1(p<0-01) for largeadenomas. Familyhistory ofother (non-colorectal) cancers(FHOC) was similar inthethreegroups. Patients with a colorectal cancer(n=171)hadmore frequently afamily history ofcancer, both colorectal (15.8%;p<O.Ol)and other cancers(35.7%; p<0.001) thangeneral population controls(n=309;FHCRC: 8/1%; FHOC:21.7%). Inalogistic model, bothfactors wereindependently related to colorectal cancers(oddsratios:1P9 (p<0.05) forFHCRC and2.1(p<0.001) for FHOC).Thesedatasuggest thatfamily history ofcolorectal cancerinfluences onlythegrowthofadenomasor their malignant transformation. Thefinding of a further predisposition toanytypeof cancerneedstobeconfirmed. (Gut1995; 37:830-834)