CIENCIASMEDICASNEWS: Recording of family history is associat

lunes, 18 de marzo de 2013

Recording of family history is associat - PubMed Mobile

Recording of family history is associated with colorectal cancer stage.

Authors

Kessels K,et al. Show all

Journal

Eur J Gastroenterol Hepatol. 2013 Apr;25(4):482-7. doi: 10.1097/MEG.0b013e32835c45a3.

Affiliation

Departments of aGastroenterology and Hepatology bPathology, University Medical Center Utrecht cDepartment of Gastroenterology and Hepatology, Sint Antonius Hospital, Utrecht, The Netherlands.

Abstract

BACKGROUND: Colorectal cancer (CRC) associated with Lynch syndrome usually presents at a relatively young age. The Revised Bethesda Guidelines advise screening for Lynch syndrome in patients diagnosed with CRC and a positive family history (FH) of CRC and other Lynch-related cancers.

OBJECTIVE: To evaluate recording of the FH and identify factors associated with recording in young patients with CRC.

PATIENTS AND METHODS: In one academic and two nonacademic hospitals, of all patients diagnosed with CRC at the age of 60 years or younger between 1999 and 2007, electronic medical records were evaluated for a recorded FH of CRC and other Lynch-related cancers. Patient and tumor characteristics were retrieved from the Dutch Comprehensive Cancer Centre and the Dutch Pathological Archive.

RESULTS: A total of 676 patients were identified. FH was recorded in 395/676 (58%) patients. From 1999 to 2007, recording improved with an odds ratio (OR) of 1.10 [95% confidence interval (CI) 1.03-1.17] per year. Stage III CRC (OR 1.71, 95% CI 1.07-2.75) and administration of chemotherapy (OR 1.84, 95% CI 1.17-2.89) were associated with recording in multivariate analysis. Other factors, including age at diagnosis, sex, surgery, radiotherapy, proximal tumor localization, poor differentiation, and mucinous histology, were not associated with recording.

CONCLUSION: A FH of CRC and other Lynch-related cancers was not recorded in ∼40% of young CRC patients and recording improved only slightly over the years. As a first step in the identification of Lynch-related cancer families, physicians should be trained to record a detailed FH in the work-up of all newly diagnosed CRC patients.