Familial risk of early and late onset cancer: nationwide prospective cohort study | BMJ

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Familial risk of early and late onset cancer: nationwide prospective cohort study | BMJ

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Familial risk of early and late onset cancer: nationwide prospective cohort study

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8076 (Published 20 December 2012)

Cite this as: BMJ 2012;345:e8076

• Cancer: dermatological
• Dermatology
• Prostate cancer
• Urological cancer
• Urological surgery
• Epidemiologic studies

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• Immunology (including allergy)
• Urology
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1. E Kharazmi, scientist1,
2. M Fallah, scientist1,
3. K Sundquist, professor23,
4. K Hemminki, professor and head of the division12

1. ¹Division of Molecular Genetic Epidemiology, German Cancer Research Centre, 69120 Heidelberg, Germany
2. ²Centre for Primary Health Care Research, Lund University, Malmö, Sweden
3. ³Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California 94305-5705, USA

1. Correspondence to: E Kharazmi E.Kharazmi{at}dkfz.de

• Accepted 20 November 2012

Abstract

Objective To determine whether familial risk of cancer is limited to early onset cases.

Design Nationwide prospective cohort study.

Setting Nationwide Swedish Family-Cancer Database.

Participants All Swedes born after 1931 and their biological parents, totalling >12.2 million individuals, including >1.1 million cases of first primary cancer.

Main outcome measures Familial risks of the concordant cancers by age at diagnosis.

Results The highest familial risk was seen for offspring whose parents were diagnosed at an early age. Familial risks were significantly increased for colorectal, lung, breast, prostate, and urinary bladder cancer and melanoma, skin squamous cell carcinoma, and non-Hodgkin’s lymphoma, even when parents were diagnosed at age 70-79 or 80-89. When parents were diagnosed at more advanced ages (≥90), the risk of concordant cancer in offspring was still significantly increased for skin squamous cell carcinoma (hazard ratio 1.9, 95% confidence interval 1.4 to 2.7), colorectal (1.6, 1.2 to 2.0), breast (1.3, 1.0 to 1.6), and prostate cancer (1.3, 1.1 to 1.6). For offspring with a cancer diagnosed at ages 60-76 whose parents were affected at age <50 all="all" cancers.="cancers." familial="familial" for="for" increased="increased" nearly="nearly" not="not" p="p" risks="risks" significantly="significantly" were="were">

Conclusion Though the highest familial risks of cancer are seen in offspring whose parents received a diagnosis of a concordant cancer at earlier ages, increased risks exist even in cancers of advanced ages. Familial cancers might not be early onset in people whose family members were affected at older ages and so familial cancers might have distinct early and late onset components.