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Relative and absolute risk of colorectal cancer for individuals with a family history: A meta-analysis

  • Author Footnotes
    1 Funded by the Associated British Insurers (ABI).
    Adam S. Butterworth
    Correspondence
    Corresponding author: Tel.: +44 1223 741 515; fax: +44 1223 740 200.
    Footnotes
    1 Funded by the Associated British Insurers (ABI).
    Affiliations
    Public Health Genetics Unit, Cambridge Genetics Knowledge Park, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
    Search for articles by this author
  • Julian P.T. Higgins
    Affiliations
    Public Health Genetics Unit, Cambridge Genetics Knowledge Park, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK

    MRC Biostatistics Unit, Cambridge, UK
    Search for articles by this author
  • Author Footnotes
    2 Senior Clinical Research Fellow of Cancer Research UK.
    Paul Pharoah
    Footnotes
    2 Senior Clinical Research Fellow of Cancer Research UK.
    Affiliations
    Public Health Genetics Unit, Cambridge Genetics Knowledge Park, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN, UK

    Department of Oncology, University of Cambridge, UK
    Search for articles by this author
  • Author Footnotes
    1 Funded by the Associated British Insurers (ABI).
    2 Senior Clinical Research Fellow of Cancer Research UK.

      Abstract

      Accurate risk estimates for individuals with a family history of colorectal cancer are important for surveillance strategies. We systematically reviewed the literature on familial risks of colorectal cancer to determine relative risk estimates for categories of family history and translated these relative risk estimates into absolute risk estimates.
      A random-effects meta-analysis pooled the effect estimates from individual studies and actuarial life-table methods converted relative into absolute risks. Fifty-nine studies were identified including 47 that estimated the relative risk of developing colorectal cancer given at least one affected first-degree relative. The pooled risk estimate was 2.24 (95% CI 2.06 to 2.43) which rose to 3.97 (95% CI 2.60 to 6.06) with at least two affected relatives. A population lifetime risk of 1.8% for a 50-year old increased to 3.4% (95% CI 2.8 to 4.0) with at least one affected relative or 6.9% (95% CI 4.5 to 10.4) with two or more. Accurate absolute risk estimates show how cancer risks vary over time, particularly by pattern of family history and age of individual at-risk.

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