Tumor spectrum in cancer family syndrome (hereditary nonpolyposis colorectal cancer)

Article Abstract:

The term 'cancer family' is often used to describe families in which a variety of cancers appear to be clustered. However, 'cancer family syndrome' is a specific syndrome also known as hereditary nonpolyposis colorectal cancer (HNPCC). It is thought that HNPCC may account for 5 percent of all cases of colorectal cancer. Some researchers divide the syndrome into two groups. Families in the first group, Lynch syndrome I, appear to develop colon cancer affecting the proximal colon as a dominant genetic trait. In Lynch syndrome II, family members are also likely to get ovarian cancer and endometrial cancer as well. It should be emphasized that members of affected families have increased risk for a variety of other cancers including small bowel cancer, stomach cancer, pancreatic and biliary cancer, and cancers of the urinary tract. A review of the cancers occurring in 40 families with cancer family syndrome was conducted to determine the spectrum of different cancers associated with the heritable disorder. A total of 315 affected family members developed 472 cancers. The most frequent was colorectal cancer, accounting for 63 percent of the neoplasms. Eight percent of the cancers were endometrial, 6 percent were stomach cancers, 4 percent were biliopancreatic cancers, and 2 percent were cancers of the urinary tract. Endometrial cancers occurred in 23 families. The distribution of other cancers outside the colon among the members of these 23 families was not significantly different than the distribution of cancers among the 17 families with no endometrial cancer. This finding raises significant doubt about the validity of using endometrial cancer as a means of dividing cancer family syndrome into two subtypes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Familial diseases

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Clinical observation on the association of gallstones and colorectal cancer

Article Abstract:

Several studies have indicated an association between gallstones and the occurrence of colorectal cancer, though this association has not always been confirmed. Two possible explanations for this association are that gallstones might contribute to the development of colorectal cancer and that the same dietary factors which contribute to the development of gallstones contribute to the development of colorectal caner as well. These hypotheses were investigated in 378 cases of colorectal cancer and 869 cases of stomach cancer. Of the colorectal cancer cases, only 23 patients (6.1 percent) had gallstones, and 4 additional patients were found to have had their gall bladder removed previously. This suggests that the presence of gallstones can not be a causative factor for colorectal cancer in the majority of cases. The relation of both colorectal cancer and gallstones to a common dietary cause is plausible, but quite difficult to conclusively confirm or deny. However, in the course of the investigation several intriguing facts became apparent. Gallstones were almost five times more common among patients with multiple colorectal cancers than among patients with only a single cancer. Curiously, the patients with both gallstones and colorectal cancer were older by an average of five years than the patients without gallstones. Likewise, the patients with the multiple cancers were older than the patients with single cancers by an average of four years. Gallstones were also found to be more common among patients with cancer of the left colon than in the right colon, and gallstones were least common among patients with rectal cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Gallstones

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Characteristics of familial colon cancer in a large population data base

Article Abstract:

In some families, a nonpolyposis colorectal cancer is inherited as an autosomal dominant gene. In these cases, the onset is relatively early in life, and the proximal colon is the usual site. This has led to the assumption that in cases of colon cancer in general, a young age at diagnosis and a proximal location may serve as possible indicators of familial colon cancer. The Utah Population Data Base was used to determine if these factors do indeed predict familial clustering of colorectal cancer. A total of 1,800 individuals with both colon cancer and genealogical records were identified. Analysis revealed that colon cancer exhibits a familial clustering in excess of chance; this clustering is independent of age of onset or distribution of tumor. Although relatives who developed colon cancer and lived outside the state of Utah could not be identified in this study, the 1,800 cases have been shown to be statistically representative. It is worth noting that the familial clustering extended beyond close relatives, and thus is unlikely to be the result of environmental factors to which all members of a family were exposed. Recently genetic markers have become available for familial adenopolyposis; these same markers may well be applied to the study of non-polyposis familial clusters to distinguish the characteristics and possible mechanisms of inheritance of colon cancers. (Consumer Summary produced by Reliance Medical Information, Inc.)

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