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      Antecedentes familiares de primer grado como factor de riesgo en el cáncer colorrectal Translated title: Family history of first degree as a risk factor for colorectal cancer

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      , , , , , , , , , , , , , , , , , , , ,
      Gaceta Sanitaria
      Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)
      Colorectal cancer, Family history, Risk factor, Case and control, MCC-Spain, Cáncer colorrectal, Antecedentes familiares, Factor de riesgo, Casos y controles, MCC-Spain

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          Abstract Objective To evaluate the association between first-degree family history and colorectal cancer (CRC). Method We analyzed data from 2857 controls and 1360 CRC cases, collected in the MCC-Spain project. The adjusted odds ratio (OR) and 95% confidence interval (95% CI) of association with the family history of CRC was estimated by non-conditional logistic regression.. Results First-degree relatives doubled the risk of CRC (OR: 2.19; 95% CI: 1.80–2.66), increasing in those with two or more (OR: 4.22; 95% CI: 2.29–7.78) and in those whose relatives were diagnosed before 50 years (OR: 3.24; 95% CI: 1.52–6.91). Regarding the association of the family history with the location, no significant differences were observed between colon and rectum, but there were in the relation of these with the age of diagnosis, having more relatives those diagnosed before 50 years (OR: 4.79; 95% CI:2.65–8.65). Conclusions First-degree relatives of CRC increase the chances of developing this tumor,they also increase when the relative is diagnosed at an early age. Therefore, it must be a target population on which to carry out prevention measures.

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          Most cited references34

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          Colorectal cancer: evidence for distinct genetic categories based on proximal or distal tumor location.

          J Bufill (1990)
          To examine studies of normal colon and colorectal cancer for evidence that the location of the primary tumor proximal or distal to the splenic flexure of the colon may determine distinct genetic categories of this disease. Studies were identified through a manual search of journals, through MEDLINE, and through review of bibliographies in identified articles. Approximately 300 articles were examined. About 150 articles were excluded because tumor location was not reported or was reported in a way that did not permit correlation with results or conclusions. Articles were selected either because the presentation of data permitted correlation of results with anatomic regions of the colon or because they were relevant to inherited colorectal cancer. RESULTS OF THE ANALYSIS: Differences were noted in biologic properties of proximal and distal segments of normal fetal and adult colonic epithelium and in the epidemiologic, pathologic, cytogenetic, and molecular features of proximal and distal colorectal cancer. Some differences correlated with the features of inherited colorectal cancer (proximal, nonpolyposis or distal, and polyposis forms). Developmental and biologic differences in proximal and distal colon may reflect differing susceptibilities to neoplastic transformation. Differences in proximal and distal colorectal cancer suggest that each may arise through different pathogenetic mechanisms. Proximal tumors appear to represent a genetically more stable form of the disease and may arise through the same mechanisms that underlie inherited nonpolyposis colon cancer. Distal tumors show evidence of greater genetic instability and may develop through the same mechanisms that underlie polyposis-associated colorectal cancer syndromes.
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            A prospective study of family history and the risk of colorectal cancer.

            A family history of colorectal cancer is recognized as a risk factor for the disease. However, as a result of the retrospective design of prior studies, the strength of this association is uncertain, particularly as it is influenced by characteristics of the person at risk and the affected family members. We conducted a prospective study of 32,085 men and 87,031 women who had not previously been examined by colonoscopy or sigmoidoscopy and who provided data on first-degree relatives with colorectal cancer, diet, and other risk factors for the disease. During the follow-up period, colorectal cancer was diagnosed in 148 men and 315 women. The age-adjusted relative risk of colorectal cancer for men and women with affected first-degree relatives, as compared with those without a family history of the disease, was 1.72 (95 percent confidence interval, 1.34 to 2.19). The relative risk among study participants with two or more affected first-degree relatives was 2.75 (95 percent confidence interval, 1.34 to 5.63). For participants under the age of 45 years who had one or more affected first-degree relatives, the relative risk was 5.37 (95 percent confidence interval, 1.98 to 14.6), and the risk decreased with increasing age (P for trend, < 0.001). A family history of colorectal cancer is associated with an increased risk of the disease, especially among younger people.
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              Heterogeneity of Colorectal Cancer Risk Factors by Anatomical Subsite in 10 European Countries: A Multinational Cohort Study

              Background & Aims Colorectal cancer located at different anatomical subsites may have distinct etiologies and risk factors. Previous studies that have examined this hypothesis have yielded inconsistent results, possibly because most studies have been of insufficient size to identify heterogeneous associations with precision. Methods In the European Prospective Investigation into Cancer and Nutrition study, we used multivariable joint Cox proportional hazards models, which accounted for tumors at different anatomical sites (proximal colon, distal colon, and rectum) as competing risks, to examine the relationships between 14 established/suspected lifestyle, anthropometric, and reproductive/menstrual risk factors with colorectal cancer risk. Heterogeneity across sites was tested using Wald tests. Results After a median of 14.9 years of follow-up of 521,330 men and women, 6291 colorectal cancer cases occurred. Physical activity was related inversely to proximal colon and distal colon cancer, but not to rectal cancer (P heterogeneity = .03). Height was associated positively with proximal and distal colon cancer only, but not rectal cancer (P heterogeneity = .0001). For men, but not women, heterogeneous relationships were observed for body mass index (P heterogeneity = .008) and waist circumference (P heterogeneity = .03), with weaker positive associations found for rectal cancer, compared with proximal and distal colon cancer. Current smoking was associated with a greater risk of rectal and proximal colon cancer, but not distal colon cancer (P heterogeneity = .05). No heterogeneity by anatomical site was found for alcohol consumption, diabetes, nonsteroidal anti-inflammatory drug use, and reproductive/menstrual factors. Conclusions The relationships between physical activity, anthropometry, and smoking with colorectal cancer risk differed by subsite, supporting the hypothesis that tumors in different anatomical regions may have distinct etiologies.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS) (Barcelona, Barcelona, Spain )
                0213-9111
                August 2022
                : 36
                : 4
                : 345-352
                Affiliations
                [16] Huelva Andalucía orgnameUniversidad de Huelva orgdiv1Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA) Spain
                [20] Barcelona orgnameL'Hospitalet de Llobregat orgdiv1Institut Català d'Oncologia (IDIBELL) orgdiv2Programa de Recerca en Epidemiologia del Càncer España
                [15] Valencia orgnameFISABIO-Salud Pública orgdiv1Área de Cáncer y Salud Pública España
                [14] Asturias Asturias orgnameUniversidad de Oviedo orgdiv1Instituto de Investigación Sanitaria del Principado de Asturias (ISPA) Spain
                [12] San Sebastián orgnameSubdirección de Salud Pública y Adicciones de Gipuzkoa orgdiv1Departamento de Salud del Gobierno Vasco España
                [13] San Sebastián orgnameInstituto de Investigaciones Sanitarias Biodonostia orgdiv1Grupo de Epidemiología de Enfermedades Crónicas y Transmisibles España
                [18] Madrid Madrid orgnameUniversidad Carlos III de Madrid orgdiv1Centro Nacional de Epidemiología orgdiv2Unidad de Cáncer y Epidemiología Ambiental Spain
                [19] Madrid orgnameIIS Puerta de Hierro orgdiv1Grupo de Investigación en Epidemiología del Cáncer, Área de Oncología y Hematología España
                [5] Barcelona orgnameL'Hospitalet de Llobregat orgdiv1Instituto de Investigación Biomédica de Bellvitge Institute (IDIBELL) orgdiv2Programa ONCOBELL España
                [1] León Castilla y León orgnameUniversidad de León orgdiv1Instituto de Biomedicina (IBIOMED) orgdiv2Grupo de Investigación en Interacciones Gen-Ambiente y Salud Spain
                [8] Pamplona orgnameInstituto de Investigación Sanitaria de Navarra (IdiSNA) España
                [11] Andalucía orgnameUniversidad de Granada orgdiv1Departamento de Medicina Preventiva y Salud Pública Spain
                [2] orgnameCIBER de Epidemiología y Salud Pública (CIBERESP) España
                [9] Santander Cantabria orgnameUniversidad de Cantabria Spain
                [10] Granada orgnameInstituto de Investigación Biosanitaria (ibs.GRANADA) España
                [6] Madrid orgnameDirección General de Salud Pública España
                [17] El Palmar Murcia orgnameUniversidad de Murcia orgdiv1Departamento de Epidemiología, Consejería de Salud, IMIB-Arrixaca Spain
                [3] Barcelona Cataluña orgnameUniversitat de Barcelona orgdiv1Facultad de Medicina orgdiv2Departamento de Ciencias Clínicas Spain
                [7] Pamplona orgnameInstituto de Salud Pública y Laboral de Navarra España
                [4] Barcelona orgnameL'Hospitalet del Llobregat orgdiv1Instituto Catalán de Oncología (ICO) orgdiv2Programa de Analítica de Datos Oncológicos (PADO) España
                Article
                S0213-91112022000400345 S0213-9111(22)03600400345
                10.1016/j.gaceta.2021.04.006
                6923a382-ce06-4582-a557-355365a30b4a

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 23 April 2021
                : 27 October 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 8
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                SciELO Spain

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                Colorectal cancer,Family history,Risk factor,Case and control,MCC-Spain,Cáncer colorrectal,Antecedentes familiares,Factor de riesgo,Casos y controles

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