Chan JA et al. (2008) Association of family history with cancer recurrence and survival among patients with stage III colon cancer. JAMA 299: 2515–2523

A family history of colorectal cancer in a first-degree relative (parent or sibling) is associated with an increased risk of developing the disease; however, it is uncertain whether family history influences recurrence or survival in patients with advanced colon cancer. Chan and colleagues investigated the outcomes of patients with stage III colon cancer who provided detailed information on their family history of colorectal cancer.

Data were analyzed from 1,087 patients enrolled in the Cancer and Leukemia Group B (CALGB) 89803 study who received adjuvant chemotherapy after surgical resection of the primary tumor. A total of 195 (17.9%) patients reported a family history of colorectal cancer in a first-degree relative. During follow-up (median 5.6 years), the incidence of cancer recurrence or death was significantly lower in the 195 patients with a family history of colorectal cancer (29%, 95% CI 23–36%) than in the 892 without a family history (38%, 95% CI 35–42%). Further reductions in the risk of cancer recurrence and mortality were observed as the number of affected relatives increased. The link between family history and outcome was independent of tumor characteristics.

The authors suggest that a number of genetic and environmental factors might influence the relationship between family history and post-treatment outcome, and they recommend further studies to determine the mechanisms responsible for reducing recurrence and mortality in patients with colon cancer who have a family history of colorectal cancer.