International Journal of Epidemiology, Vol 28, 603-608, Copyright © 1999 by International Epidemiological Association
PA Newcomb, JO Taylor and A Trentham-Dietz
BACKGROUND: Family history of colorectal cancer has been consistently
associated with an increased personal risk of this disease. Since evidence
suggests that hormones are related to colon cancer risk in women, the
effect of family history on large bowel incidence may be modified according
to endogenous and exogenous hormone levels. METHODS: We analysed data from
a population-based case-control study of female colorectal cancer to
evaluate family history and cancer risk. Cases (n = 702) were female
residents of Wisconsin with a new diagnosis of colorectal cancer,
identified through a statewide tumour registry. Controls (n = 2274) were
randomly selected from lists of licensed drivers and from rosters of
Medicare beneficiaries. All relative risks (RR) were adjusted for age, body
mass index, smoking and alcohol history, education, and use of hormone
replacement therapy. RESULTS: Compared with women who reported no history
of cancer in a first degree relative, women with a family history had an RR
of 2.07 (95% confidence interval [CI]: 1.60-2.68). Regardless of which
parent was affected, risks were increased about twofold, while sibling
history was associated with about a 50% increase in risk. Risk was greater
if more than one family member was affected (RR 3.65, 95% CI: 1.81-7.37).
The association between family history and risk was stronger for colon
cancer than for rectal cancer. There were no indications that exogenous
hormonal factors, notably hormone replacement use, modified these risks.
There was a suggestion that high parity attenuated the risks associated
with family history (P = 0.07). CONCLUSIONS: These results confirm that
family history of colorectal cancer is associated with a doubling of risk
for large bowel cancer in women; some histories were associated with
greater risk. This relation was not substantially different among subgroups
of women with varying exogenous and endogenous hormone exposures.
ARTICLES
Interactions of familial and hormonal risk factors for large bowel cancer in women
Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
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